ArticleThe Lancet. Global health2022
The effect of primary health care on tuberculosis in a nationwide cohort of 7·3 million Brazilian people: a quasi-experimental study.
Article in The Lancet. Global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Record linkage in tuberculosis epidemiological surveillance in Brazil: systematic methodological literature review.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2026Pooled it
- The intersecting effects of race/ethnicity, wealth, education, and gender on AIDS among 28.3 million Brazilians.Nature communications · 2026Article
- Cost Analysis of Tuberculosis Disease in the Case of Tuberculosis Control Dispensary.Thoracic research and practice · 2026Article
- Conditional cash transfer and mortality among interpersonal violence victims: A cohort study.PLoS medicine · 2026Article
- Cash Transfers and Psychiatric Hospitalization for At-Risk Populations in Brazil.JAMA network open · 2026Article
- Temporal changes in pediatric tuberculosis incidence in Rio de Janeiro (2010-2023): An analysis using the Joinpoint model.PloS one · 2026Article
- Civil society perspectives on tuberculosis care for people living with HIV in Brazil: A study informed by Social Representations Theory.PLOS global public health · 2026Article
- Intersectional impact of cash transfers on AIDS among 12.3 million Brazilian women.Nature human behaviour · 2025Article
- Primary health care response to tuberculosis treatment in Brazilian cities during the COVID-19 pandemic: a mixed-method study.Global health action · 2025Article
- Epidemiological, Socioeconomic, and Health Service Factors Associated with Tuberculosis Treatment Interruption in Brazil.Epidemiologia (Basel, Switzerland) · 2025Article
- Impact of the COVID-19 pandemic on unfavorable tuberculosis outcomes: a comparative analysis of unhoused and general populations.BMC public health · 2025Article
- Emerging Research Trends on Medication Adherence in Tuberculosis Treatment: A Bibliometric Study of Research Between 2015 and 2024 to Inform Future Research Trajectory.Patient preference and adherence · 2025Review
- Analysis of vulnerabilities and negatives outcomes of tuberculosis treatment in the Municipality of São Paulo, 2019 and 2021.Revista da Sociedade Brasileira de Medicina Tropical · 2025Article
- Conditional cash transfers and mortality in people hospitalised with psychiatric disorders: A cohort study of the Brazilian Bolsa Família Programme.PLoS medicine · 2024Article
- A pilot program to improve TB care with primary and specialty care coordination in TB public health clinic.IJTLD open · 2024Article
- The impact of primary health care on AIDS incidence and mortality: A cohort study of 3.4 million Brazilians.PLoS medicine · 2024Article
- Article
- The effect of conditional cash transfers on tuberculosis incidence and mortality is determined by ethnoracial and socioeconomic factors: a cohort study of 54 million individuals in Brazil.Research square · 2024Article
- Income determines the impact of cash transfers on HIV/AIDS: cohort study of 22.7 million Brazilians.Nature communications · 2024Article
- Risk Factors for Unfavorable Outcomes of Tuberculosis in Korea: Implications for Patient-Centered Care in Tuberculosis Treatment.Journal of Korean medical science · 2024Article
Corrections and comments
- Commented on by
Authors and funding
12 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundUniversal health coverage is one of the WHO End TB Strategy priority interventions and could be achieved-particularly in low-income and middle-income countries-through the expansion of primary health care. We evaluated the effects of one of the largest primary health-care programmes in the world, the Brazilian Family Health Strategy (FHS), on tuberculosis morbidity and mortality using a nationwide cohort of 7·3 million individuals over a 10-year study period.
methodsWe analysed individuals who entered the 100 Million Brazilians Cohort during the period Jan 1, 2004, to Dec 31, 2013, and compared residents in municipalities with no FHS coverage with residents in municipalities with full FHS coverage. We used a cohort design with multivariable Poisson regressions, adjusted for all relevant demographic and socioeconomic variables and weighted with inverse probability of treatment weighting, to estimate the effect of FHS on tuberculosis incidence, mortality, cure, and case fatality. We also performed a range of stratifications and sensitivity analyses.
findingsFHS exposure was associated with lower tuberculosis incidence (rate ratio [RR] 0·78, 95% CI 0·72-0·84) and mortality (0·72, 0·55-0·94), and was positively associated with tuberculosis cure rates (1·04, 1·00-1·08). FHS was also associated with a decrease in tuberculosis case-fatality rates, although this was not statistically significant (RR 0·84, 95% CI 0·55-1·30). FHS associations were stronger among the poorest individuals for all the tuberculosis indicators.
interpretationCommunity-based primary health care could strongly reduce tuberculosis morbidity and mortality and decrease the unequal distribution of the tuberculosis burden in the most vulnerable populations. During the current marked rise in global poverty due to the COVID-19 pandemic, investments in primary health care could help protect against the expected increases in tuberculosis incidence worldwide and contribute to the attainment of the End TB Strategy goals.
fundingTB Modelling and Analysis Consortium (Bill & Melinda Gates Foundation), Wellcome Trust, and Brazilian Ministry of Health. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.