Conditional cash transfer program and Leprosy incidence: analysis of 12.9 million families from the 100 million Brazilian cohort

dc.creatorPescarini, Júlia Moreira
dc.creatorWilliamson, Elizabeth
dc.creatorIchihara, Maria Yury Travassos
dc.creatorFiaccone, Rosemeire Leovigildo
dc.creatorForastiere, Laura
dc.creatorRamond, Anna
dc.creatorNery, Joilda Silva
dc.creatorPenna, Maria Lucia Fernandes
dc.creatorStrina, Agostino
dc.creatorReis, Sandra
dc.creatorSmeeth, Liam
dc.creatorRodrigues, Laura Cunha
dc.creatorBrickley, Elizabeth B.
dc.creatorPenna, Gerson Oliveira
dc.creatorBarreto, Maurício Lima
dc.date2021-01-05T13:03:36Z
dc.date2021-01-05T13:03:36Z
dc.date2020
dc.date.accessioned2023-09-26T22:15:16Z
dc.date.available2023-09-26T22:15:16Z
dc.identifierPESCARINI, Julia Moreira et al. Conditional Cash Transfer Program and Leprosy Incidence: Analysis of 12.9 Million Families From the 100 Million Brazilian Cohort. American Journal of Epidemiology, [Baltimore], v. 189, n. 12, p. 1547–1558, Jul. 2020.
dc.identifier0002-9262
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/45505
dc.identifier10.1093/aje/kwaa127
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8876890
dc.descriptionConselho Nacional das Fundações Estaduais de Amparo à Pesquisa (CONFAP), Economic and Social Research Council (ESRC), Medical Research Council (MRC), Biotechnology and Biological Sciences Research Council (BBSRC), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Apoio à Pesquisa do Distrito Federal (FAP-DF) for Neglected Diseases (FAP-DF 193.000.008/ 2016 and MR/N017250/1), the Wellcome Trust (202912/B/16/Z), e Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).
dc.descriptionLeprosy is a neglected tropical disease predominately affecting poor and marginalized populations. To test the hypothesis that poverty-alleviating policies might be associated with reduced leprosy incidence, we evaluated the association between the Brazilian Bolsa Familia (BFP) conditional cash transfer program and new leprosy case detection using linked records from 12,949,730 families in the 100 Million Brazilian Cohort (2007–2014). After propensity score matching BFP beneficiary to nonbeneficiary families, we used Mantel-Haenszel tests and Poisson regressions to estimate incidence rate ratios for new leprosy case detection and secondary endpoints related to operational classification and leprosy-associated disabilities at diagnosis. Overall, cumulative leprosy incidence was 17.4/100,000 person-years at risk (95% CI: 17.1, 17.7) and markedly higher in “priority” (highburden) versus “nonpriority” (low-burden) municipalities (22.8/100,000 person-years at risk, 95% confidence interval (CI): 22.2, 23.3, compared with 14.3/100,000 person-years at risk, 95% CI: 14.0, 14.7). After matching, BFP participation was not associated with leprosy incidence overall (incidence rate ratio (IRR)Poisson = 0.97, 95% CI: 0.90, 1.04) but was associated with lower leprosy incidence when restricted to families living in highburden municipalities (IRRPoisson = 0.86, 95% CI: 0.77, 0.96). In high-burden municipalities, the association was particularly pronounced for paucibacillary cases (IRRPoisson = 0.82, 95% CI: 0.68, 0.98) and cases with leprosyassociated disabilities (IRRPoisson = 0.79, 95% CI: 0.65, 0.97). These findings provide policy-relevant evidence that social policies might contribute to ongoing leprosy control efforts in high-burden communities.
dc.formatapplication/pdf
dc.languageeng
dc.publisherOxford University Press
dc.relationhttps://www.arca.fiocruz.br/handle/icict/42846
dc.rightsopen access
dc.subjectLeprosy
dc.subjectPoverty
dc.subjectPublic Assistance
dc.subjectEpidemiology
dc.subjectBrazil
dc.subjectIncome
dc.subjectBolsa Familia Program
dc.subjectCash transfers
dc.subjectHansen’s disease
dc.subjectinequality
dc.subjectInfectious diseases
dc.subjectPoverty
dc.subjectProgramas Sociais
dc.subjectHanseníase
dc.subjectDoenças Transmissíveis
dc.subjectPobreza
dc.subjectBrasil
dc.titleConditional cash transfer program and Leprosy incidence: analysis of 12.9 million families from the 100 million Brazilian cohort
dc.typeArticle


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