Temporal trend of tuberculosis incidence and its spatial distribution in Macapa - Amapa

Autor(es):Mostrar menos -

Giacomet, Clovis Luciano ^[1] ; Santos, Marcio Souza ^[1] ; Berra, Thais Zamboni ^[1] ; Alves, Yan Mathias ^[1] ; Alves, Luana Seles ^[1] ; Paulino da Costa, Fernanda Bruzadelli ^[1] ; Vieira Ramos, Antonio Carlos ^[1] ; Crispim, Juliane de Almeida ^[1] ; Monroe, Aline Aparecida ^[1] ; Carvalho Pinto, Ione ^[1] ; Fiorati, Regina Celia ^[1] ; Moraes Arcoverde, Marcos Augusto ^[2] ; Gomes, Dulce ^[3] ; de Freitas, Giselle Lima ^[4] ; Yamamura, Mellina ^[5] ; Arcencio, Ricardo Alexandre ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Escola Enfermagem Ribeirao Preto, Ribeirao Preto, SP - Brazil

^[2] Univ Oeste Parana, Escola Enfermagem, Foz Do Iguacu, PR - Brazil

^[3] Univ Evora, Dept Matemat, Evora - Portugal

^[4] Univ Fed Minas Gerais, Fac Enfermagem, Belo Horizonte, MG - Brazil

^[5] Univ Fed Sao Carlos, Fac Enfermagem, Sao Carlos, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Revista de Saúde Pública; v. 55, 2021.
• Citações Web of Science: 0

Resumo

OBJECTIVE: To evaluate the temporal trend of tuberculosis incidence after the implementation of the rapid molecular test (RMT-TB), to identify whether tuberculosis presents seasonal variation and to classify the territory according to case density and risk areas in Macapa, Amapa. METHODS: Ecological study of tuberculosis cases registered in the Sistema de Informacao de Agravos de Notificacao (SINAN - Information System for Notifiable Diseases) between 2001 and 2017. We used the Prais-Winsten test to classify the temporal trend of incidence and the interrupted time series to identify changes in the temporal trend before and after the implementation of the rapid molecular test, and to verify seasonality in the municipality. The Kernel estimator was used to classify case density and scan statistics to identify areas of tuberculosis risk. RESULTS: A total of 1,730 cases were identified, with a decreasing temporal trend of tuberculosis incidence (-0.27% per month, 95%CI -0.13 to -0.41). The time series showed no change in level after the implementation of the GeneXpert (R) MTB/RIF molecular test; however, the incidence increased in the post-test period (+2.09% per month, 95%CI 0.92 to 3.27). Regarding the seasonal variation, it showed growth (+13.7%/month, 95%CI 4.71 to 23.87) from December to June, the rainy season - called amazon winter season -, and decrease (-9.21% per month, CI95% -1.37 to -16.63) in the other periods. We classified areas with high density of cases in the Central and Northern districts using Kernel and identified three protection clusters, SC1 (RR = 0.07), SC2 (RR = 0.23) and SC3 (RR = 0.36), and a high-risk cluster, SC4 (RR = 1.47), with the scan statistics. CONCLUSION: The temporal trend of tuberculosis incidence was decreasing in the time series; however, detection increased after the introduction of RMT-TB, and tuberculosis showed seasonal behavior. The case distribution was heterogeneous, with a tendency to concentrate in vulnerable and risk territories, evidencing a pattern of disease inequality in the territory. (AU)

• Processo FAPESP: 18/03700-7 - O impacto do gene Xpert MTB/RIF na detecção da Tuberculose e da Tuberculose Multidroga-Resistente e seu padrão espacial em Ribeirão Preto-SP
• Beneficiário: Thaís Zamboni Berra
• Modalidade de apoio: Bolsas no Brasil - Doutorado