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Progress toward eliminating TB and HIV deaths in Brazil, 2001–2015: a spatial assessment

Overview of attention for article published in BMC Medicine, September 2018
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  • Above-average Attention Score compared to outputs of the same age (60th percentile)

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Title
Progress toward eliminating TB and HIV deaths in Brazil, 2001–2015: a spatial assessment
Published in
BMC Medicine, September 2018
DOI 10.1186/s12916-018-1131-6
Pubmed ID
Authors

Jennifer M. Ross, Nathaniel J. Henry, Laura A. Dwyer-Lindgren, Andrea de Paula Lobo, Fatima Marinho de Souza, Molly H. Biehl, Sarah E. Ray, Robert C. Reiner, Rebecca W. Stubbs, Kirsten E. Wiens, Lucas Earl, Michael J. Kutz, Natalia V. Bhattacharjee, Hmwe H. Kyu, Mohsen Naghavi, Simon I. Hay

Abstract

Brazil has high burdens of tuberculosis (TB) and HIV, as previously estimated for the 26 states and the Federal District, as well as high levels of inequality in social and health indicators. We improved the geographic detail of burden estimation by modelling deaths due to TB and HIV and TB case fatality ratios for the more than 5400 municipalities in Brazil. This ecological study used vital registration data from the national mortality information system and TB case notifications from the national communicable disease notification system from 2001 to 2015. Mortality due to TB and HIV was modelled separately by cause and sex using a Bayesian spatially explicit mixed effects regression model. TB incidence was modelled using the same approach. Results were calibrated to the Global Burden of Disease Study 2016. Case fatality ratios were calculated for TB. There was substantial inequality in TB and HIV mortality rates within the nation and within states. National-level TB mortality in people without HIV infection declined by nearly 50% during 2001 to 2015, but HIV mortality declined by just over 20% for males and 10% for females. TB and HIV mortality rates for municipalities in the 90th percentile nationally were more than three times rates in the 10th percentile, with nearly 70% of the worst-performing municipalities for male TB mortality and more than 75% for female mortality in 2001 also in the worst decile in 2015. The same municipality ranking metric for HIV was observed to be between 55% and 61%. Within states, the TB mortality rate ratios by sex for municipalities in the worst decile versus the best decile varied from 1.4 to 2.9, and HIV varied from 1.4 to 4.2. The World Health Organization target case fatality rate for TB of less than 10% was achieved in 9.6% of municipalities for males versus 38.4% for females in 2001 and improved to 38.4% and 56.6% of municipalities for males versus females, respectively, by 2014. Mortality rates in municipalities within the same state exhibited nearly as much relative variation as within the nation as a whole. Monitoring the mortality burden at this level of geographic detail is critical for guiding precision public health responses.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 90 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 90 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 15 17%
Researcher 9 10%
Student > Ph. D. Student 9 10%
Student > Bachelor 7 8%
Student > Doctoral Student 6 7%
Other 10 11%
Unknown 34 38%
Readers by discipline Count As %
Medicine and Dentistry 10 11%
Mathematics 5 6%
Computer Science 5 6%
Nursing and Health Professions 5 6%
Immunology and Microbiology 5 6%
Other 19 21%
Unknown 41 46%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 September 2018.
All research outputs
#7,753,732
of 23,706,059 outputs
Outputs from BMC Medicine
#2,698
of 3,586 outputs
Outputs of similar age
#132,296
of 337,204 outputs
Outputs of similar age from BMC Medicine
#58
of 73 outputs
Altmetric has tracked 23,706,059 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 3,586 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 44.6. This one is in the 24th percentile – i.e., 24% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 337,204 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 60% of its contemporaries.
We're also able to compare this research output to 73 others from the same source and published within six weeks on either side of this one. This one is in the 21st percentile – i.e., 21% of its contemporaries scored the same or lower than it.