[Social determinants and self-reported tuberculosis: National Research by Household Sample, metropolitan areas, Brazil]. / Determinantes sociais e autorrelato de tuberculose nas regiões metropolitanas conforme a Pesquisa Nacional por Amostra de Domicílios, Brasil.

ABSTRACT

OBJECTIVE: To verify the association between individual demographic and socioeconomic variables and the incidence of self-reported tuberculosis in Brazil. METHODS: This cross-sectional study used data from the health supplement of the 2008 National Research by Household Sample (PNAD) for Brazil's metropolitan areas. An analysis was done of the association between demographic, social, and health service use variables and the odds of having been diagnosed with tuberculosis, according to data from PNAD. Socioeconomic status was assessed based on per capita household income, educational attainment, race, and number of persons per bedroom. Having a place of reference for health care and having health insurance were used as proxy for access to health care, and having been to a doctor in the previous 12 months was used as a variable of health service use. Due to the complex sample design of PNAD, logistic regression was used, taking into account the design effect. RESULTS: The odds of being diagnosed with tuberculosis increased with age and were greater among men. Within the nine metropolitan areas, the effect of income was observed starting at half the minimum wage, with odds decreasing as income increased. Not having seen a doctor in the previous year and having finished high school reduced the odds of reporting tuberculosis by 60%. CONCLUSIONS: Improving the living conditions of vulnerable population segments and facilitating their access to diagnosis should be primary strategies for controlling tuberculosis.