Evidence map›Paper›PMID 32819980›Full record

ArticleBMJ open2020

Social determinants of deaths from pneumonia and tuberculosis in children in Brazil: an ecological study.

Thaís Zamboni Berra, Ivaneliza Simionato de Assis, Luiz Henrique Arroyo, Marcos Augusto Moraes Arcoverde, Josilene Dália Alves, Laura Terenciani Campoy, Luana Seles Alves, Juliane de Almeida Crispim, Alexandre Tadashi Inomata Bruce, Yan Mathias Alves and 5 more

Abstract read
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Thaís Zamboni BerraDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil thaiszamboni@live.com.ORCID 0000-0002-4163-8719
Ivaneliza Simionato de AssisDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Luiz Henrique ArroyoDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Marcos Augusto Moraes ArcoverdeDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Josilene Dália AlvesDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Laura Terenciani CampoyDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Luana Seles AlvesDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Juliane de Almeida CrispimDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Alexandre Tadashi Inomata BruceDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Yan Mathias AlvesDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Felipe Lima Dos SantosDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.ORCID 0000-0001-5606-9478
Severina Alice da Costa UchôaDepartment of Collective Health, Centro Universitario do Rio Grande do Norte, Natal, Brazil.
Regina Celia FioratiDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.
Luis LapãoInternational Public Health and Biostatistics, Universidade Nova de Lisboa, Lisboa, Portugal.
Ricardo Alexandre ArcêncioDepartment of Maternal-Infant and Public Health, Universidade de Sao Paulo, Ribeirão Preto, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify the risk areas of deaths due to unspecified pneumonia and tuberculosis (TB) in children, and to identify if there is a relationship between these events with higher TB incidence and social determinants.

methodsEcological study carried out in Brazil. All cases of TB or unspecified pneumonia deaths in children under 5 years of age reported between 2006 and 2016 were included and collected through Department of Informatics of the Unified Health System (Brazil's electronic database). The Spatial Scan Statistics was used to identify areas at higher risk of dying from this event. The spatial association was verified through the Getis-Ord techniques. The Bivariate Moran Global Index was used to verify the spatial autocorrelation between the two events. To identify the association of TB and pneumonia deaths with endemic areas of pulmonary TB and social determinants, four explanatory statistical models were identified.

resultsA total of 21 391 cases of pneumonia and 238 cases of TB were identified. Spatial scanning analysis enabled the detection of four clusters of risk for TB (relative risk, RR, between 3.30 and 18.18) and 22 clusters for pneumonia (RR between 1.38 and 5.24). The spatial association of the events was confirmed (z-score 3.74 and 64.34) and spatial autocorrelation between events (Moran Index:0.031 (p=0.001)). The zero-inflated negative binomial distribution was chosen, and an association for both events was identified with the TB incidence rate (OR 5.3, 95% CI 2.85 to 9.84; OR 6.63, 95% CI 5.62 to 7.81), with the Gini Index (OR 1.78, 95% CI 1.12 to 2.82; OR 4.22, 95% CI 3.63 to4.92). Primary care coverage showed an inverse association for both events (OR 0.10, 95% CI 0.67 to 0.17; OR 0.18, 95% CI 0.15 to 0.21) for pneumonia). Finally, a family that benefited from the Bolsa Família Programme had an inverse association for deaths from pneumonia (OR 0.81, 95% CI 0.52 to 1.25).

conclusionsThe results do not just contribute to reduce mortality in children, but mainly contribute to prevent premature deaths through identification of critical areas in Brazil, which is crucial to qualify health surveillance services.

Indexed as

PneumoniaTuberculosisTuberculosis, PulmonaryBrazilChildChild, PreschoolHumansIncidenceSocial Determinants of Healthchilddeathspneumoniaspatial analysistuberculosis

Identifiers

PMID32819980
PMCPMC7443304

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.