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      The incidence of tuberculosis and its relation to social inequalities: Integrative Review Study on PubMed Base Translated title: La incidencia de la tuberculosis y su relación con las desigualdades sociales: Estudio de revisión integradora en la Base PubMed Translated title: A ocorrência da tuberculose e sua relação com as desigualdades sociais: Estudo de revisão Integrativa na Base PubMed

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          Abstract

          Abstract Objective: to identify how the literature presents the relation between tuberculosis and social inequalities. Method: integrative review in which the combination of the descriptors “tuberculosis” and “social iniquity” guided the search for articles available in PubMed. A total of 274 articles were identified, and after reading the title and abstract, 13 studies were selected. The empirical material was analyzed according to the hermeneutics, highlighting the variables related to social inequalities, seeking to understand the main themes that embody the association between tuberculosis and social inequalities. Results: In general, the literature presents the social inequalities as factors that can interfere in the cure and/or control of the disease, such as age, income, unemployment, unskilled labor, access to health services, among others. Therefore, it does not include a deeper relationship between the organization of society and the production of the disease. Conclusion and implications for practice: A comprehensive understanding of tuberculosis disease is required, in order to expand interventions to support the control and elimination of the disease and, above all, the reduction of social inequalities. The understanding of tuberculosis as a disease enables expanding strategies to face it.

          Translated abstract

          Resumen Objetivo: identificar cómo la literatura presenta la relación de la tuberculosis y desigualdades sociales. Método: revisión integrativa en que la combinación de los descriptores “tuberculosis” y “social iniquity” orientaron la investigación de artículos disponibles en el PubMed. Se identificaron 274 artículos, y después de la lectura del título y resumen, se seleccionaron 13 estudios. El material empírico fue analizado según la hermenéutica, con destaque a las variables relacionadas a las desigualdades sociales, buscando aprehender los principales temas que corporifican la asociación entre tuberculosis y desigualdades sociales. Resultados: En general, la literatura presenta las desigualdades sociales como factores que pueden interferir en la cura y/o control de la enfermedad, especialmente: edad, ingresos, desempleo, trabajo no calificado, acceso a servicios de salud, entre otros. No incluye, por lo tanto, una relación más profunda entre la organización de la sociedad y la producción de la enfermedad. Conclusión e implicación para la práctica: Se requiere comprensión totalizante de la enfermedad por tuberculosis, con la finalidad de ampliar intervenciones para que apoyen el control y la eliminación de la enfermedad y, sobre todo, la reducción de las desigualdades sociales. La comprensión de la tuberculosis como una enfermedad relacionada con la determinación social posibilita ampliar las estrategias para su enfrentamiento.

          Translated abstract

          Resumo Objetivo: Identificar como a literatura apresenta a relação entre a tuberculose e as desigualdades sociais. Método: Revisão integrativa em que a combinação dos descritores “tuberculosis” e “social inequity” orientaram a pesquisa de artigos disponíveis no PubMed. Foram identificados 274 artigos e, após a leitura do título e resumo, foram selecionados 13 estudos. O material empírico foi analisado segundo a hermenêutica, com destaque às variáveis relacionadas às desigualdades sociais, buscando-se apreender os principais temas que corporificam a associação entre a tuberculose e as desigualdades sociais. Resultados: De modo geral, a literatura apresenta as desigualdades sociais como fatores, que podem interferir na cura e/ou no controle da doença, com destaque para: idade, renda, desemprego, trabalho não qualificado, acesso aos serviços de saúde, entre outros. Não inclui, portanto, uma relação mais profunda entre a organização da sociedade e a produção da doença. Conclusão e Implicações para a prática: Requer-se compreensão totalizante do adoecimento por tuberculose, com a finalidade de ampliar intervenções que apoiem o controle e a eliminação da enfermidade e, sobretudo, a redução das desigualdades sociais. A compreensão da tuberculose como uma doença relacionada à determinação social possibilita ampliar as estratégias para o seu enfrentamento.

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          Most cited references21

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          Revisão integrativa: conceitos e métodos utilizados na enfermagem

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            The Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) project: an operational assessment.

            Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru. To evaluate socio-economic interventions for strengthening TB control by improving uptake of TB care and prevention services. Barriers to TB control were characterised by interviews with TB-affected families. To reduce these barriers, a multidisciplinary team offered integrated community and household socio-economic interventions aiming to: 1) enhance uptake of TB care by education, community mobilisation and psychosocial support; and 2) reduce poverty through food and cash transfers, microcredit, microenterprise and vocational training. An interim analysis was performed after the socio-economic interventions had been provided for 2078 people in 311 households of newly diagnosed TB patients for up to 34 months. Poverty (46% earned
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              Stopping tuberculosis: a biosocial model for sustainable development.

              Tuberculosis transmission and progression are largely driven by social factors such as poor living conditions and poor nutrition. Increased standards of living and social approaches helped to decrease the burden of tuberculosis before the introduction of chemotherapy in the 1940s. Since then, management of tuberculosis has been largely biomedical. More funding for tuberculosis since 2000, coinciding with the Millennium Development Goals, has yielded progress in tuberculosis mortality but smaller reductions in incidence, which continues to pose a risk to sustainable development, especially in poor and susceptible populations. These at-risk populations need accelerated progress to end tuberculosis as resolved by the World Health Assembly in 2015. Effectively addressing the worldwide tuberculosis burden will need not only enhancement of biomedical approaches but also rebuilding of the social approaches of the past. To combine a biosocial approach, underpinned by social, economic, and environmental actions, with new treatments, new diagnostics, and universal health coverage, will need multisectoral coordination and action involving the health and other governmental sectors, as well as participation of the civil society, and especially the poor and susceptible populations. A biosocial approach to stopping tuberculosis will not only target morbidity and mortality from disease but would also contribute substantially to poverty alleviation and sustainable development that promises to meet the needs of the present, especially the poor, and provide them and subsequent generations an opportunity for a better future.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ean
                Escola Anna Nery
                Esc. Anna Nery
                Universidade Federal do Rio de Janeiro (, RJ, Brazil )
                1414-8145
                2177-9465
                2020
                : 24
                : 1
                : e20180367
                Affiliations
                [2] São Paulo São Paulo orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina orgdiv2Departamento de Moléstias Infecciosas e Parasitárias Brazil
                [3] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Escola Paulista de Enfermagem orgdiv2Departamento de Saúde Coletiva Brazil
                [1] São Paulo São Paulo orgnameUniversidade de São Paulo orgdiv1Escola de Enfermagem orgdiv2Departamento de Enfermagem em Saúde Coletiva Brazil
                Article
                S1414-81452020000100213
                10.1590/2177-9465-ean-2018-0367
                4dabb66e-6af6-46ee-8404-b1fda086efad

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 17 December 2018
                : 30 July 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 0
                Product

                SciELO Brazil

                Categories
                Research

                Salud Pública,Tuberculose,Tuberculosis,Health Inequalities,Social Inequity,Public Health,Enfermagem em Saúde Comunitária,Community Health Nursing,Desigualdades em Saúde,Iniquidade Social,Saúde Pública,Enfermería en Salud Comunitaria,Desigualdades en la Salud,Inequidad Social

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