The association between a conditional cash transfer programme and malaria incidence: a longitudinal ecological study in the Brazilian Amazon between 2004 and 2015

BMC Public Health

Maurício Lima Barreto¹  Mauro Niskier Sanchez²  Luiz Felipe Pinto³  Layana Costa Alves⁴  Gerson Oliveira Penna⁵  Joilda Silva Nery⁶  Thomas Hone⁷  Pedro Luiz Tauil⁸ 

[1] Center for Data and Knowledge Integration for Health, CIDACS, Oswaldo Cruz Foundation, FIOCRUZ, Rua Mundo, 121, Trobogy, CEP: 41745-715, Salvador/BA, Brazil;Department of Collective Health, University of Brasília, UNB, Campus Universitário Darcy Ribeiro, s/n, Asa Norte, CEP: 70910-900, Brasília/DF, Brazil;Tropical Medicine Centre, University of Brasília, UNB, Campus Universitário Darcy Ribeiro, s/n, Asa Norte, CEP: 70.904.970, Brasília/DF, Brazil;Department of Medicine in Primary Health Care, School of Medicine, Federal University of Rio de Janeiro, UFRJ, Rua Laura de Araújo, 36 – 2 andar. Cidade Nova, CEP: 20211-170, Rio de Janeiro/RJ, Brazil;Postdoctoral Fellow in the Institute of Hygiene and Tropical Medicine at Nova Medical School, R. da Junqueira 100, 1349-008, Lisbon, Portugal;Fiocruz School of Government, Oswaldo Cruz Foundation, EFG/FIOCRUZ, Avenida L3 Norte, s/n, Campus Universitário Darcy Ribeiro, Gleba A, CEP: 70.904-130, Brasília/DF, Brazil;Institute of Collective Health, Federal University of Bahia, UFBA, Rua Basílio da Gama, s/n, Campus Universitário Canela, CEP: 40.110-040, Salvador/BA, Brazil;Fiocruz School of Government, Oswaldo Cruz Foundation, EFG/FIOCRUZ, Avenida L3 Norte, s/n, Campus Universitário Darcy Ribeiro, Gleba A, CEP: 70.904-130, Brasília/DF, Brazil;Tropical Medicine Centre, University of Brasília, UNB, Campus Universitário Darcy Ribeiro, s/n, Asa Norte, CEP: 70.904.970, Brasília/DF, Brazil;Institute of Collective Health, Federal University of Bahia, UFBA, Rua Basílio da Gama, s/n, Campus Universitário Canela, CEP: 40.110-040, Salvador/BA, Brazil;Department of Collective Health, Federal University of Vale do São Francisco, UNIVASF, Rua da Aurora, s/n, General Dutra, CEP: 48607-190, Paulo Afonso/BA, Brazil;Public Health Policy Evaluation Unit, Imperial College, Imperial College London, Charing Cross Hospital, W6 8RP, London, UK;Tropical Medicine Centre, University of Brasília, UNB, Campus Universitário Darcy Ribeiro, s/n, Asa Norte, CEP: 70.904.970, Brasília/DF, Brazil;

关键词: Conditional cash transfer;    Epidemiology;    Malaria;    Prevention & control;    Social determinants of health;    Vector borne disease;   

DOI  :  10.1186/s12889-021-11255-0

来源: Springer

【 摘 要 】

BackgroundMalaria causes 400 thousand deaths worldwide annually. In 2018, 25% (187,693) of the total malaria cases in the Americas were in Brazil, with nearly all (99%) Brazilian cases in the Amazon region. The Bolsa Família Programme (BFP) is a conditional cash transfer (CCT) programme launched in 2003 to reduce poverty and has led to improvements in health outcomes. CCT programmes may reduce the burden of malaria by alleviating poverty and by promoting access to healthcare, however this relationship is underexplored. This study investigated the association between BFP coverage and malaria incidence in Brazil.MethodsA longitudinal panel study was conducted of 807 municipalities in the Brazilian Amazon between 2004 and 2015. Negative binomial regression models adjusted for demographic and socioeconomic covariates and time trends were employed with fixed effects specifications.ResultsA one percentage point increase in municipal BFP coverage was associated with a 0.3% decrease in the incidence of malaria (RR = 0.997; 95% CI = 0.994–0.998). The average municipal BFP coverage increased 24 percentage points over the period 2004–2015 corresponding to be a reduction of 7.2% in the malaria incidence.ConclusionsHigher coverage of the BFP was associated with a reduction in the incidence of malaria. CCT programmes should be encouraged in endemic regions for malaria in order to mitigate the impact of disease and poverty itself in these settings.

【 授权许可】

CC BY