Spatial analysis of tuberculosis in children under 15 years of age and socioeconomic risk: an ecological study in Paraíba, Brazil, 2007-2016

Spatial and temporal analysis of tuberculosis incidence in Guinea-Bissau, 2018 to 2020

OBJECTIVE

to analyze the epidemiological profile, spatial and temporal distribution of tuberculosis in Guinea-Bissau from 2018 to 2020.

METHODS

an ecological study, carried out in Guinea-Bissau, considering new cases of tuberculosis. Spatial analysis of areas was used to verify tuberculosis distribution in the country, and time series were used to identify incidence evolution over the years of study.

RESULTS

a total of 6,840 new cases of tuberculosis were reported. Tuberculosis incidence rate in the country ranged from 36.8 to 267.7 cases/100,000 inhabitants, with emphasis on the regions of Bissau and Biombo (over 90 cases/100,000). By using time series, it was possible to observe an increase in case incidence over the years of study.

CONCLUSIONS

the study made it possible to identify the epidemiological profile of tuberculosis in Guinea-Bissau, spatial distribution heterogeneity, in addition to identifying the disease evolution over the years of investigation.

Tuberculosis Disability Adjusted Life Years, Colombia 2010-2018

Estimating the burden of tuberculosis disease is relevant for assessing and identifying population health status and progress in policies and programs aimed at epidemic control. The objective of this study was to estimate disability-adjusted life years attributable to Tuberculosis in Colombia 2010-2018. A longitudinal descriptive study was conducted. The variables, sex, age groups and origin were studied. This study included 110,475 cases of morbidity and 8514 cases of mortality. Indicators of years of life lost, years of life with disability and disability-adjusted life years at the subnational level were determined using the methodology of the World Health Organization. With the results of this last indicator, an epidemiological risk stratification was carried out. The DALY rate of the study period was 684 (95% CI 581.2-809.1) per 100,000 inhabitants. According to sex, 68.4% occurred in men; for every DALY in women, 2.21 occur in men. People of productive age (15 to 69 years) account for 56% of DALYs. Amazonas (1857.1 CI 95% 1177.1-2389.6) was the territorial entity with the highest rate. A total of 51.5% of the territorial entities of departmental order of the country are of high burden for Tuberculosis. For the first time in Colombia, a comprehensive assessment of the status of the disease burden at a subnational (departmental) territorial level attributable to Tuberculosis is being carried out using the updated World Health Organization methodology. The results obtained allow us to specify that there is a knowledge gap in terms of the realization and clear understanding of the burden of the disease in Colombia. There are territorial gaps that are necessary to know in order to plan, develop, implement and redirect policies to improve health and eliminate disparities according to the territorial context.

Tuberculosis Mortality in Children under Fifteen Years of Age: Epidemiological Situation in Colombia, 2010-2018

Pediatric tuberculosis is a serious infectious disease and a hidden global epidemic. The objective of this study was to describe the epidemiological situation of tuberculosis mortality in children under 15 years of age in Colombia in the period 2010-2018. A longitudinal descriptive study was conducted. The variables sex, age groups, and origin were studied. This study had 260 cases for analysis and was carried out in three phases. The first phase was the determination of the sociodemographic and clinical characteristics. The second phase was the construction of indicators by territorial entities. The third phase was stratification into four epidemiological situations according to the mortality rate and years of life lost. The median age was 7 years (range 0-14), 66.5% of cases were pulmonary tuberculosis (97.7% without bacteriological confirmation), 14.3781 years of life lost were recorded (95% CI: 142.811-168.333), and in children under 10-14 years, the loss was 110,057. Amazonas had the highest adjusted YLL rate (3979.7). In total, 36.4% of the territories had a high mortality, and 30.3% adjusted to the situation designated as 1. This is the first study that has used composite indicators to address the problem of premature mortality from childhood tuberculosis in Colombia. Our results allow us to specify that this disease remains a challenge for public health. It requires models of care and differential strategies by region. It also requires ensuring opportunities in diagnosis with sensitive methods, as well as intersectoral work for the optimal approach.

Risk-prone territories for spreading tuberculosis, temporal trends and their determinants in a high burden city from São Paulo State, Brazil

Objectives

To identify risk-prone areas for the spread of tuberculosis, analyze spatial variation and temporal trends of the disease in these areas and identify their determinants in a high burden city.

Methods

An ecological study was carried out in Ribeirão Preto, São Paulo, Brazil. The population was composed of pulmonary tuberculosis cases reported in the Tuberculosis Patient Control System between 2006 and 2017. Seasonal Trend Decomposition using the Loess decomposition method was used. Spatial and spatiotemporal scanning statistics were applied to identify risk areas. Spatial Variation in Temporal Trends (SVTT) was used to detect risk-prone territories with changes in the temporal trend. Finally, Pearson's Chi-square test was performed to identify factors associated with the epidemiological situation in the municipality.

Results

Between 2006 and 2017, 1760 cases of pulmonary tuberculosis were reported in the municipality. With spatial scanning, four groups of clusters were identified with relative risks (RR) from 0.19 to 0.52, 1.73, 2.07, and 2.68 to 2.72. With the space–time scan, four clusters were also identified with RR of 0.13 (2008–2013), 1.94 (2010–2015), 2.34 (2006 to 2011), and 2.84 (2014–2017). With the SVTT, a cluster was identified with RR 0.11, an internal time trend of growth (+ 0.09%/year), and an external time trend of decrease (− 0.06%/year). Finally, three risk factors and three protective factors that are associated with the epidemiological situation in the municipality were identified, being: race/brown color (OR: 1.26), without education (OR: 1.71), retired (OR: 1.35), 15 years or more of study (OR: 0.73), not having HIV (OR: 0.55) and not having diabetes (OR: 0.35).

Conclusion

The importance of using spatial analysis tools in identifying areas that should be prioritized for TB control is highlighted, and greater attention is necessary for individuals who fit the profile indicated as “at risk” for the disease.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-022-07500-5.