Abstract
The aim of this study was to analyze the spatial distribution of the tuberculosis endemic in Rio de Janeiro State from 2002 to 2011. A retrospective study was conducted in the state of Rio de Janeiro from 2002 to 2011. Spatial analysis techniques were used to describe the distribution of tuberculosis incidence in the state. Multilevel Poisson regression model was used to access the relationship of tuberculosis and the following factors: "sex", "age-group" and "diagnostic year" (individual-level factors). Demographic density and municipality were also included in the model as contextual-level factors. A reduction in endemic tuberculosis was observed over the years. The highest incidence rates were concentrated on the south coast of the state, covering Rio de Janeiro City (capital) and neighboring cities. We detected a significant clustering of high TB incidence rates on the south coast of the state and a cluster of low incidence in the northeastern region of state. The risk of tuberculosis was higher in early 2000s, in males and in 40-59 age group. Metropolitan regions are important risk areas for the spread of tuberculosis. These findings could be used to plan control measures according to the characteristics of each region.
Highlights
Spatial analysis studies are important tools for epidemiological surveillance
The state of Rio de Janeiro is located in the southeast of Brazil and is the third most populous state of the country
We used the georeferenced mesh of municipalities of the state of Rio de Janeiro, available from the “Brazilian Institute of Geography and Statistic” website, to prepare thematic maps
Summary
Spatial analysis studies are important tools for epidemiological surveillance. Their use in public health provides a better understanding of the dynamics of the disease processes and diffusion as well as the relationship between the disease and the environment[1]. Some studies have evaluated tuberculosis (TB) distribution using spatial analysis tool[2,3,4,5,6,7]. In Portugal, the spatial distribution of TB incidence rates (2004-2006) showed high values in large cities (Porto, Lisbon and Setúbal Peninsula), in north-eastern and in southern Portugal[8]. A Brazilian study (2002-2009) detected strong spatial auto correlation of TB rates and remarked that these rates were notably higher in urban areas on the eastern seaboard and in the west of the country[9]. Sales et al.[2], detected high incidence rates of childhood TB in the major metropolitan areas of Espírito Santo State in southeastern Brazil in 2000-2007
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