Abstract
Tuberculosis is closely related to living conditions. This study classifies Brazilian municipalities according to the occurrence of tuberculosis (TB) and drug-resistant TB (DR-TB) cases and describes them with regard to the population's health conditions, tuberculosis control indicators, demographic and socioeconomic profile. In 2014, 327 municipalities reported DR-TB cases. Integrated regions of development or metropolitan regions accounted for 80.1% of national DR-TB cases. Municipalities with DR-TB cases had worse TB outcome indicators, but higher culture test percentages, and more inhabitants and better socioeconomic indicators. The 3,644 municipalities with TB cases, but without DR-TB cases, had the worst socioeconomic indicators among the three groups. The 1,594 municipalities without TB cases had the lowest rates of unemployment and AIDS detection and greater coverage of primary healthcare. The different profiles found in the study can sustain improved national interventions for TB and drug-resistant TB control in Brazil.
Highlights
Tuberculosis (TB) is a serious public health problem of global relevance[1]
As for drug-resistant TB cases (DR-TB), 1,574 cases were distributed across 327 municipalities of residence
The municipalities with DR-TB cases had a lower percentage of cured cases (p < 0.01), and a higher share of loss to follow-up (p = 0.00) and transference or unknown outcomes (p = 0.00) (Table 1)
Summary
Tuberculosis (TB) is a serious public health problem of global relevance[1]. Some 10.4 million people affected by TB were estimated for 20151. Brazil recorded 63,189 new TB cases, an incidence rate of 30.9/100 thousand inhabitants[3]. Reducing disease incidence requires early case detection and appropriate treatment until cure. In this context, the proportion of drug-resistant TB cases (DR-TB) reduces the share of successful treatments, making them lengthier, costlier and more toxic[1,2]. In 2015, 3.9% of new TB cases and 21% of previously treated cases, respectively, had MDR-TB or rifampicin-resistant TB worldwide. In Brazil, 1.5% of new cases and 8% of retreatments, respectively, had MDR-TB or rifampicin-resistant TB1
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