title: Effectiveness of a conditional cash transfer programme on TB cure rate: a retrospective cohort study in Brazil.
abstract: BACKGROUND
  Despite the efforts of the National Tuberculosis Programme, TB cure rates in Brazil are sub-optimal. The End TB Strategy for post-2015 identifies conditional cash transfer interventions as powerful tools to improve TB control indicators, including TB cure rate. This study aims to inform the new policy by evaluating the role of the Bolsa Familia Programme (BFP), one of the largest conditional cash transfer programmes in the world, on TB cure rates in Brazil.
  
  
  METHODS
  We undertook a retrospective cohort study, based on an unprecedented record linkage of socioeconomic and health data, to compare cases of patients newly diagnosed with TB in 2010 receiving BFP cash benefits (n=5788) with those who did not (n=1467) during TB treatment. We used Poisson regression with robust variance to estimate the relative risks for TB cure adjusted for known confounders.
  
  
  RESULTS
  The cure rate among patients exposed to BFP during TB treatment was 82.1% (4752/5788), 5.2% higher than among those not exposed. This was confirmed after controlling for TB type, diabetes mellitus, HIV status and other relevant clinical and socioeconomic covariates (RR=1.07, 95% CI 1.04 to 1.11 for cure rates among BFP beneficiaries). This association seemed higher for patients not under directly observed treatment (RR=1.11; 95% CI 1.05 to 1.16).
  
  
  CONCLUSIONS
  Although further research is needed, this study suggests that conditional cash transfer programmes can contribute to improve TB cure rate in Brazil.
authors.affiliation: Tropical Medicine Department, University of Brasília, Brasilía, DF, Brazil aninhawt@gmail.com.
authors.forename: Ana W
authors.initials: AW
authors.lastname: Torrens
authors.affiliation: Oswaldo Cruz Foundation (FIOCRUZ), Brasília, DF, Brazil.
authors.forename: Davide
authors.initials: D
authors.lastname: Rasella
authors.affiliation: Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.
authors.forename: Delia
authors.initials: D
authors.lastname: Boccia
authors.affiliation: Federal University of Espírito Santo, Maruipe, Vitória, DF, Brazil.
authors.forename: Ethel L N
authors.initials: EL
authors.lastname: Maciel
authors.affiliation: Federal University of Bahia, Institute of Collective Health, Salvador, Bahia, DF, Brazil.
authors.forename: Joilda S
authors.initials: JS
authors.lastname: Nery
authors.affiliation: University of California Berkeley, Berkeley, CA, USA.
authors.forename: Zachary D
authors.initials: ZD
authors.lastname: Olson
authors.affiliation: National Tuberculosis Program/Ministry of Health of Brazil, Brasília, DF, Brazil.
authors.forename: Draurio C N
authors.initials: DC
authors.lastname: Barreira
authors.affiliation: Federal University of Brasilia, Brasília, DF, Brazil.
authors.forename: Mauro N
authors.initials: MN
authors.lastname: Sanchez
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002648:Child; D005260:Female; D006078:Government Programs; D061889:Healthcare Financing; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D011204:Poverty Areas; D011632:Public Assistance; D012044:Regression Analysis; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control* / Q000628:therapy; D055815:Young Adult
keywords: Adherence; Conditional cash transfer; Social protection; Tuberculosis