Abstract
ObjectiveThis study analysed clinical and sociodemographic aspects and follow-up for notified cases of tuberculosis (TB) and explored inequalities in incidence rates and outcome by colour or race and the geographic macro-regions of Brazil.MethodsThis paper reports the results of a population-based descriptive epidemiological study of all notified cases of TB in Brazil during the period from 01/01/2008 to 31/12/2011. We analysed sociodemographic and clinical variables according to colour or race (white, black, Asian, mixed, and indigenous) and geographic macro-regions of the country (North, Northeast, Central-West, South, and Southeast).ResultsDuring the study period, the average incidence of TB in Brazil was 36.7 cases per 100,000 inhabitants, with the highest rates occurring in the North and Southeast regions. The analysis of TB notifications by colour or race revealed that the indigenous population presented the highest incidence rates in all macro-regions except the South, where higher rates were reported in black patients. ‘Cured’ was the most frequently reported treatment outcome for all skin colour categories. The highest cure rate occurred among the indigenous population (76.8%), while the lowest cure rate occurred among the black population (70.7%). Rates of treatment default were highest among blacks (10.5%) and lowest among the indigenous population (6.9%). However, the fatality rate was similar across race categories, varying between 2.8% and 3.8% for whites and the indigenous population, respectively. The lowest cure rates were observed when follow-up was inadequate (58.3%), and the highest was observed when the follow-up was classified as excellent (96.8%).ConclusionsThis study revealed that—apart from the heterogeneous distribution of TB among the Brazilian macro-regions—ethnic-racial inequalities exist in terms of clinical-epidemiological characteristics and incidence rates as well as follow-up for cases undergoing treatment. The highest rates of TB occurred among the indigenous people.
Highlights
Tuberculosis (TB) has been recognized as an important cause of illness and death in humans for thousands of years [1]
The analysis of TB notifications by colour or race revealed that the indigenous population presented the highest incidence rates in all macro-regions except the South, where higher rates were reported in black patients
The highest cure rate occurred among the indigenous population (76.8%), while the lowest cure rate occurred among the black population (70.7%)
Summary
This study analysed clinical and sociodemographic aspects and follow-up for notified cases of tuberculosis (TB) and explored inequalities in incidence rates and outcome by colour or race and the geographic macro-regions of Brazil. Data Availability Statement: The data underlying the findings cannot be made publicly available in order to protect patient privacy and comply with Brazilian law. Data from notification tuberculosis cases can be obtained upon request from Secretariat of Health Surveillance (Secretaria de Vigilância em Saúde) of Ministry of Health, Brasília, DF, Brazil. Readers may contact Dr Dácio de Lyra Rabello Neto (CGIAE-DASIS-SVS) at dacio.rabello@saude.gov.br or please contact the coordinator the National Program for Tuberculosis Control, Denise Arakaki (denise.arakaki@saude.gov.br).
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