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Vaz IF, Paiva NS, Viana PVDS. Spatial-temporal evolution of tuberculosis incidence rates in indigenous and non-indigenous people of Brazil, from 2011 to 2022. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023; 26:e230055. [PMID: 38088714 PMCID: PMC10715319 DOI: 10.1590/1980-549720230055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To describe the space-time evolution of TB incidence rates (TI) in indigenous and non-indigenous people, according to the Federative Units (UF) of Brazil, from 2011 to 2022. METHODS Ecological, temporal, and spatial study on new tuberculosis cases in Brazil among indigenous and non-indigenous populations. Data from the Notifiable Diseases Information System (Sinan) were collected from 2011 to 2022 and stratified by Federal Unit, explored and statistically analyzed using R software version 4.2.3. RESULTS The mean TI among indigenous populations in Brazil was 71.7 new cases per 100,000 inhabitants, while for non-indigenous populations it was 28.6/100,000 inhabitants. The regions of the country that presented the highest (mean) incidence among indigenous populations were: Central-West (102.8/100,000 inhabitants), Southeast (99.6/100,000 inhabitants), and North (79.9/100,000 inhabitants). For non-indigenous populations the highest incidence was in the North region (36.5/100,000 inhabitants), followed by the Southeast (31.3/100,000), and the Northeast (27,4/100,000 inhabitants). The analysis showed that the highest incidence of TB cases among indigenous populations occurred in the states of: SP, RO, RJ, MS, MT e PA. CONCLUSION High incidence of the disease compared to the non-indigenous population show the need for a specific approach to address the health needs of these populations. Regional disparities in incidence indicate the need to address socioeconomic and infrastructure issues that affect the health of indigenous populations.
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Affiliation(s)
- Isabela Freitas Vaz
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca – Rio de Janeiro (RJ), Brazil
| | - Natália Santana Paiva
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva – Rio de Janeiro (RJ), Brazil
| | - Paulo Victor de Sousa Viana
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Centro de Referência Professor Hélio Fraga – Rio de Janeiro (RJ), Brazil
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Ferreira TF, Santos AMD, Oliveira BLCAD, Caldas ADJM. Tendência da tuberculose em indígenas no Brasil no período de 2011-2017. CIENCIA & SAUDE COLETIVA 2020; 25:3745-3752. [DOI: 10.1590/1413-812320202510.28482018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 02/11/2019] [Indexed: 11/21/2022] Open
Abstract
Resumo O objetivo deste artigo é analisar a tendência da tuberculose (TB) em indígenas no Brasil no período de 2011-2017. Trata-se de um estudo ecológico realizado com todos os casos novos de TB em indígenas notificados no Sistema de Informação de Agravos de Notificação, durante o período 2011 a 2017. Foram confeccionados mapas temáticos para acompanhamento da evolução espaço-temporal da TB na população indígena em cada ano. Para o estudo da tendência utilizou-se o modelo de regressão linear generalizada de Prais-Winsten. No período em estudo, foram notificados 6.520 casos de TB em indígenas. A incidência geral de TB em indígenas no Brasil foi de 109/100.000 habitantes. Na análise por regiões do país, as maiores incidências ocorreram nas regiões Centro-Oeste, Norte e Sudeste. Na análise por UF, as maiores incidências foram encontradas no Mato Grosso, São Paulo, Rondônia, Mato Grosso do Sul, Acre, Maranhão, Pará e Rio de Janeiro. A tendência da doença nos indígenas foi estável tanto no país quanto na maioria das suas regiões e UF. A TB afeta desproporcionalmente os indígenas brasileiros e o presente estudo ao identificar regiões e UF prioritárias pode contribuir para a elaboração e fortalecimento de ações de controle mais específicas.
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Malacarne J, Heirich AS, Cunha EAT, Kolte IV, Souza-Santos R, Basta PC. Performance of diagnostic tests for pulmonary tuberculosis in indigenous populations in Brazil: the contribution of Rapid Molecular Testing. J Bras Pneumol 2019; 45:e20180185. [PMID: 31017227 PMCID: PMC6733740 DOI: 10.1590/1806-3713/e20180185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 12/07/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy of rapid molecular testing as a diagnostic tool and estimate the incidence of smear-positive pulmonary tuberculosis among the indigenous population. METHODS This is an epidemiological study based on secondary data. We calculated the incidence of smear-positive pulmonary tuberculosis between January 1st, 2011 and December 31, 2016, and the performance of bacilloscopy and rapid molecular testing in diagnosing pulmonary tuberculosis compared to sputum culture (standard test). RESULTS We included 4,048 cases of indigenous people with respiratory symptoms who provided sputum samples for analysis. Among them, 3.7%, 6.7%, and 3.7% had positive results for bacilloscopy, sputum culture, and rapid molecular testing, respectively. The mean incidence of pulmonary tuberculosis was 269.3/100 thousand inhabitants. Rapid molecular testing had 93.1% sensitivity and 98.2% specificity, compared to sputum culture. Bacilloscopy showed 55.1% sensitivity and 99.6% specificity. CONCLUSIONS Rapid molecular testing can be useful in remote areas with limited resources and a high incidence of tuberculosis, such as indigenous villages in rural regions of Brazil. In addition, the main advantages of rapid molecular testing are its easy handling, fast results, and the possibility of detecting rifampicin resistance. Together, these attributes enable the early start of treatment, contributing to reduce the transmission in communities recognized as vulnerable to infection and disease.
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Affiliation(s)
- Jocieli Malacarne
- . Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
| | | | | | - Ida Viktoria Kolte
- . Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
| | - Reinaldo Souza-Santos
- . Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
| | - Paulo Cesar Basta
- . Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
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de Castro DB, de Seixas Maciel EMG, Sadahiro M, Pinto RC, de Albuquerque BC, Braga JU. Tuberculosis incidence inequalities and its social determinants in Manaus from 2007 to 2016. Int J Equity Health 2018; 17:187. [PMID: 30594205 PMCID: PMC6310934 DOI: 10.1186/s12939-018-0900-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background Brazil is among the 30 countries with high-burden of tuberculosis worldwide, and Manaus is the capital with the highest tuberculosis incidence. The accelerated economic and population growth in Manaus in the last 30 years has strengthened the process of social stratification that may result in population groups that are less favored in terms of healthcare and are vulnerable to infection and illness due to tuberculosis. This study aimed to characterize inequalities associated with tuberculosis incidence in relation to the socioeconomic and demographic characteristics of the resident population of Manaus and to identify their determinants from 2007 to 2016. Methods An ecological study was conducted using the data from the Diseases Notification Information System. Tuberculosis incidence rates by population characteristics (gender, ethnicity, and socioeconomic level) were calculated for each year, studied, and represented in equiplot charts. To measure the disparity of tuberculosis incidence in the resident population in Manaus, the Gini index of tuberculosis in each neighborhood was calculated based on the incidence rates of the census sectors. A thematic map was constructed to represent the spatial distribution of tuberculosis incidence inequality. Linear regression models were used to identify the relationship between the tuberculosis incidence inequality and its social determinants. Results From 2007 to 2016, there was an increase in the tuberculosis incidence in Manaus, together with an increase in incident inequality among genders, ethnic groups, and socioeconomic level. The incidence of tuberculosis inequality was associated with the inequalities of its possible determinants (Gini of the proportion of male population, Gini of the proportion of indigenous population, Gini of the proportion of illiteracy, Gini of income, Gini of the proportion of households connected to the water network, and Gini of the mean number of bathrooms per inhabitant), the per capita income, and the proportion of cases with laboratory confirmation. Conclusions Disparities in tuberculosis incidence in the resident population in neighborhoods can be explained by the sociodemographic and economic heterogeneity. Our findings recommend that public policies and tuberculosis control strategies consider differences in the determinants of tuberculosis inequality for the development of specific actions for each population group.
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Affiliation(s)
- Daniel Barros de Castro
- Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil.,Escola Nacional de Saúde Pública Sérgio Arouca - Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | | | - José Ueleres Braga
- Escola Nacional de Saúde Pública Sérgio Arouca - Fiocruz, Rio de Janeiro, Brazil. .,Instituto de Medicina Social - UERJ, Rio de Janeiro, Brazil. .,PECTI-SAÚDE / Fundação de Amparo a Pesquisa do estado do Amazonas, Manaus, Brazil.
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do Socorro Nantua Evangelista M, Maia R, Toledo JP, de Abreu RG, Braga JU, Barreira D, Trajman A. Second month sputum smear as a predictor of tuberculosis treatment outcomes in Brazil. BMC Res Notes 2018; 11:414. [PMID: 29954436 PMCID: PMC6022340 DOI: 10.1186/s13104-018-3522-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/20/2018] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE The value of sputum smear microscopy (SSM) after 2 months of treatment in the management of pulmonary tuberculosis is controversial. We analysed second month-SSM conversion as a predictor of treatment success in Brazil. RESULTS Overall successful outcome rate was 89.4%. The predictive value of second month-SSM conversion for successful outcomes was 85.2% 72,479/85,118), while the predictive value of non-conversion for unfavourable outcomes was 26.9% (2712/10,071). Unfavourable treatment outcomes were twice more likely among patients who did not convert (adjusted OR = 2.06; 1.97-2.16).
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Affiliation(s)
- Maria do Socorro Nantua Evangelista
- Brazil, Ministry of Health, National Tuberculosis Program, Federal District, Brasília, Brazil. .,University of Brasilia (UnB), Federal District, Brasília, Brazil. .,, SHIS QI 27 Conj. 10 Casa 8. Lago Sul, Brasília, 71675-100, Brazil.
| | - Rosalia Maia
- Brazil, Ministry of Health, National Tuberculosis Program, Federal District, Brasília, Brazil
| | - João Paulo Toledo
- Brazil, Ministry of Health, National Tuberculosis Program, Federal District, Brasília, Brazil
| | | | - José Uereles Braga
- University of the State of Rio de Janeiro (UERJ), Rio De Janeiro, RJ, Brazil
| | | | - Anete Trajman
- Federal University of Rio de Janeiro (UFRJ), Rio De Janeiro, RJ, Brazil.,McGill University, Montreal, QC, Canada
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Mendes AM, Bastos JL, Bresan D, Leite MS. Epidemiologic situation of tuberculosis in Rio Grande do Sul: an analysis about Sinan's data between 2003 and 2012 focusing on indigenous peoples. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 19:658-669. [PMID: 27849278 DOI: 10.1590/1980-5497201600030015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/13/2016] [Indexed: 11/21/2022] Open
Abstract
Objective: This article analyzes the epidemiological situation of tuberculosis in the state of Rio Grande do Sul, emphasizing the indigenous population. The data are based on the Information System of Grievance Notification (Sinan) between 2003 and 2012. Methods: The notified cases of tuberculosis were analyzed according to age, sex, zone of residence, input type, means of diagnosis, clinical form, anti-HIV exam, medical care, supervised treatment (in Portuguese, TDO), closure, and race. Results: The highest incidence rates in the period were among Afro-Brazilians, yellow, and indigenous peoples. The cases affected mainly adult men living in urban areas. Indigenous peoples showed the highest rates of notifications among people aged less than 10 years (12%). In the sputum test, missing information and not-performed exams reached more than 50.0% in all periods and groups. The cure was more prevalent among white people (66.2%); indigenous, brown, and Afro-Brazilian people presented the lowest cure rates: 59.4, 58.4, and 60%, respectively. Conclusion: Tuberculosis is one of the biggest problems in Rio Grande do Sul. The actions of diagnosis, clinical form, and treatment of the cases have not been implemented as proposed. The indigenous peoples' situation is similar and diverse at the same time in comparison with other peoples from different areas of Brazil. Nevertheless, it is unfavorable on a balanced evaluation of the whole scenario. Furthermore, the discrepancies among races are evident: the indigenous and Afro-Brazilian peoples fill the spread sheet, in general terms, on the worst situation, whereas the white people fill the data with the best health situation.
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Affiliation(s)
| | - João Luiz Bastos
- Universidade Federal de Santa Catarina - Florianópolis (SC), Brasil
| | - Deise Bresan
- Universidade Federal de Mato Grosso do Sul - Campo Grande (MS), Brasil
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Caldart RV, Marrero L, Basta PC, Orellana JDY. Fatores associados à pneumonia em crianças Yanomami internadas por condições sensíveis à atenção primária na região norte do Brasil. CIENCIA & SAUDE COLETIVA 2016; 21:1597-606. [DOI: 10.1590/1413-81232015215.08792015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/10/2015] [Indexed: 11/21/2022] Open
Abstract
Resumo Em países em desenvolvimento, a pneumonia é a principal causa de adoecimento e morte na infância, principalmente em grupos vulneráveis. O objetivo deste estudo foi analisar os fatores associados à pneumonia em crianças Yanomami internadas por condições sensíveis à atenção primária (ICSAP). As internações foram divididas em dois grupos: i) pneumonias e ii) demais causas, de acordo com a lista brasileira de ICSAP. Foram estimadas taxas ajustadas de ICSAP e utilizou-se a regressão logística não condicional para analisar fatores associados. Mais de 90% dos registros foram considerados ICSAP. A taxa padronizada de ICSAP foi 18,6/1.000. As chances de internação por pneumonia foram 2,7 (IC: 1,3-5,4) vezes maiores em crianças de 0,1 a 5,9 meses; 1,9 (IC: 1,1-3,3) vezes maiores nas crianças que tiveram a duração da hospitalização variando de 8 a 14 dias; e 3,0 (IC: 1,2-7,5) vezes maiores nas crianças com diagnóstico secundário de desnutrição. O excesso de internações evitáveis é um forte indício da baixa qualidade das ações em terras indígenas e do limitado acesso à atenção primária, contrariando o modelo assistencial proposto pelo subsistema de saúde indígena no Brasil que, em tese, deveria privilegiar tecnologias assistenciais ancoradas na atenção primária.
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Marques M, Ruffino-Netto A, Marques AMC, Andrade SMOD, Silva BAKD, Pontes ERJC. [Pulmonary tuberculosis among residents of municipalities in Mato Grosso do Sul State, Brazil, bordering on Paraguay and Bolivia]. CAD SAUDE PUBLICA 2016; 30:2631-42. [PMID: 26247992 DOI: 10.1590/0102-311x00191513] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 07/10/2014] [Indexed: 11/22/2022] Open
Abstract
This study analyzed the epidemiological profile of pulmonary tuberculosis from 2007 to 2010 in municipalities (counties) in Mato Grosso do Sul State, Brazil, that border on Paraguay and Bolivia. In the border region, the incidence rate (49.1/100,000 inhabitants), mortality rate (4.0/100,000 inhabitants), and treatment dropout rate (11.3%) were 1.6, 1.8, and 1.5 times higher than in the non-border region. Among indigenous individuals in the border region, the rates for incidence (253.4/100,000 inhabitants), mortality (11.6/100,000 inhabitants), and HIV/TB co-infection (1.9/100,000 inhabitants) were 6.4, 3.2, and 1.9 times higher than in non-indigenous individuals in this region. Living in the border regions was inversely associated with HIV/TB co-infection. Indigenous ethnicity was associated statistically with not abandoning TB treatment. The study concludes that the population residing in these municipalities along the border is exposed to high risk of pulmonary TB and TB mortality and treatment dropout, thus requiring special health surveillance interventions.
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Affiliation(s)
- Marli Marques
- Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil
| | - Antonio Ruffino-Netto
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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Guimarães MD. Pulmonary tuberculosis in Brazilian indians: a picture of this context depicted through radiography. Radiol Bras 2015; 48:V-VI. [PMID: 26543294 PMCID: PMC4633068 DOI: 10.1590/0100-3984.2015.48.5e1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Marcos Duarte Guimarães
- PhD, Supervisor of Medical Residency in Imaging Diagnosis at Hospital Heliópolis, Professor, Program of Post-graduation stricto sensu, A.C.Camargo Cancer Center, São Paulo, SP, Brazil. E-mail:
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