# Social protection in areas vulnerable to tuberculosis: a mixed methods study in São Luís, Maranhão

## TL;DR

This study explores how social protection and geographic factors influence tuberculosis treatment in São Luís, Brazil.

## Contribution

The study combines spatial analysis and interviews to link social benefits with tuberculosis outcomes in vulnerable areas.

## Key findings

- 13 high-risk geographic clusters for tuberculosis were identified using spatial scanning.
- A positive relationship was found between receiving social benefits and patient improvement.
- Geographic and social factors are crucial for improving health monitoring and disease prevention.

## Abstract

to analyze the risk areas for tuberculosis and the influences of social protection on the development of treatment for the disease in the municipality of São Luís, Maranhão.

this is explanatory sequential mixed method research. In the quantitative phase, the data were obtained from the Notifiable Diseases Information System from 2010 to 2019, with georeferencing being carried out to identify areas vulnerable to tuberculosis. In the qualitative phase, semi-structured interviews were carried out with individuals who received social benefits.

7,381 cases were geocoded, and, from the purely spatial scanning analysis, it was possible to identify 13 spatial clusters of risk. As for the interviews, there was a positive relationship between patient improvement and receiving benefits.

geographic space and social determinants are relevant for reorienting monitoring actions for the conditions that generate the health-disease process.

analisar as áreas de risco para a tuberculose e as influências da proteção social no desenvolvimento do tratamento para a doença no município de São Luís, Maranhão.

trata-se de pesquisa de método misto sequencial explanatório. Na fase quantitativa, os dados foram obtidos do Sistema de Informação de Agravos de Notificação de 2010 a 2019, sendo realizado georreferenciamento para identificação das áreas vulneráveis à tuberculose. Na fase qualitativa, realizaram-se entrevistas semiestruturadas com indivíduos que recebiam benefício social.

foram geocodificados 7.381 casos, e, a partir da análise de varredura puramente espacial, foi possível identificar 13 aglomerados espaciais de risco. Quanto às entrevistas, verificou-se uma relação positiva entre a melhora dos pacientes e o recebimento de benefícios.

o espaço geográfico e os determinantes sociais são relevantes para reorientação das ações de monitoramento das condições geradoras do processo saúde-doença.