TUBERCULOSIS IN THE STATE OF ALAGOAS: SPATIAL AND TEMPORAL ANALYSIS BETWEEN 2010 AND 2015

• Published in: Mundo da saúde (1995) Vol. 43; no. 1; pp. 129 - 150
• Main Authors: Geronimo Bispo Santos, Franklin, Silva de Paiva, João Paulo, Correia Ferro de Araújo, Emmylly Maria, Cavalcanti Leal, Thiago, Dornels Freire de Souza, Carlos, Tavares Duailibe, Felipe
• Format: Journal Article
• Language: English
• Published: Centro Universitário São Camilo 01.01.2019
• Subjects: tuberculosis. epidemiology descriptive. epidemiology and biostatistics. public health
• ISSN: 0104-7809; 1980-3990
• DOI: 10.15343/0104-7809.20194301129150

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Each year, more than 70 thousand new cases of the disease are registered in Brazil. The aim of this study was to analyze the tendency and the spatial distribution of tuberculosis in the state of Alagoas in the 2010-2015 period and to identify possible areas of under-reported cases or high risk of transmission. This was a mixed ecological study. Six indicators were analyzed: incidence of tuberculosis, incidence of bacilliferous pulmonary tuberculosis, mortality, HIV/TB coinfection, cure and treatment abandonment. In the temporal analysis, the regression model by inflection points (Joinpoint) was used to identify the APC (Annual Percentual Change) and the trends were classified as increasing, stationary and decreasing. In the spatial analysis, Local Empirical Bayesian Method and Global and Local Moran statistics were used. Significance adopted was 5% with a 95% confidence interval (CI 95%). There was a statistically significant tendency of reduction in the general rate of tuberculosis incidence (APC -5.6; p = 0.01) and the proportion of abandonment (APC -10.9; p = 0.048). However, the proportion of coinfection presented a growing tendency (APC 7.9; p = 0.01). The other indicators presented a stationary pattern. The Bayesian method reduced random data fluctuation. The Moran statistic showed a significant autocorrelation for the incidence of general and bacilliferous pulmonary tuberculosis, with a concentration in the Metropolitan Region of Maceió. Tuberculosis represents a major public health problem in Alagoas. The Mesoregion of the Alagoano Sertão (woodlands) appears as an area where under-reporting of cases occurs. The study demonstrated the need to strengthen actions to cope with the disease.