Diagnosis of pulmonary tuberculosis in the state of São Paulo: temporal trend of indicators in the context of the Covid-19 pandemic

• Grant number: 24/10681-0
• Support Opportunities: Scholarships abroad - Research Internship - Post-doctor
• Start date: January 02, 2025
• End date: March 01, 2025
• Field of knowledge: Health Sciences - Nursing - Public Health Nursing
• Principal Investigator: Aline Aparecida Monroe
• Grantee: Mariana Gaspar Botelho Funari de Faria
• Supervisor: Dulce Maria de Oliveira Gomes
• Host Institution: Escola de Enfermagem de Ribeirão Preto (EERP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Institution abroad: Universidade de Évora, Portugal
• Associated to the scholarship: 23/06383-0 - Diagnosis of pulmonary tuberculosis in the state of São Paulo: temporal trend of indicators in the context of the covid-19 pandemic, BP.PD

Abstract

Tuberculosis (TB) is a disease with important social relevance, as around 4,500 people died from the disease in 2020 in Brazil. Since 2003, TB has been among the Brazilian government's priorities. However, despite progress towards the goal of ending TB, important challenges relating to prevention, diagnosis and treatment still remain. With the emergence of Covid-19, this devastating health scenario weakened the performance of national TB control programs, with abrupt repercussions on the diagnosis of the disease, whose efforts were directed towards policies to combat the pandemic. Given this context, this proposal aims to analyze the trend in indicators of access to pulmonary TB diagnosis before, during and after the Covid-19 pandemic in the state of São Paulo. This is an ecological time series study, whose study population will be made up of new TB cases reported between 2014 and 2023 in the state. Sociodemographic, clinical, diagnostic and outcome variables of the cases will be collected from TB WEB and SITE-TB. After collection, monthly performance indicators for the state of São Paulo in TB diagnosis will be calculated during the period proposed by the study. To study the behavior of indicators over time, various time series statistical techniques will be applied to describe the pattern of these indicators, namely in terms of their trends, seasonality, cyclicality and irregularities. Therefore, when evaluating whether the Covid-19 pandemic caused an immediate impact (change in level) and/or progressive impact (change in trend) on the series values, appropriate time series techniques will be applied to detect changes in structure in time series (sometimes also called interrupted time series). If structural changes have been detected in the indicators, the size of these impacts will be estimated.