Evaluation of the epidemiological aspects and the impact of COVID-19 on tuberculosis notifications in São Paulo

Talita Antunes Antoniolli Pontes,Janine Pedroso Scolaro,Fernanda Stumpf Tonin,Renan Augusto Ramos,Astrid Wiens,Bruno Salgado Riveros

doi:10.4322/2179-443x.0754

Abstract

Objective: This study aimed to analyze the incidence and epidemiological profile of tuberculosis (TB) cases registered in a region of the State of São Paulo (SP) and to assess the impact of COVID19 on TB incidence and completeness of notifications. Methods: This is a retrospective crosssectional study analyzing reports of adult patients with TB, who were notified in the TB-Web from January 2010 to December 2020. Sociodemographic (e.g. sex, race and scholarity) and clinical variables (e.g., clinical form, types of cases and comorbidities) were collected and analyzed. The completeness of TB notifications and the impact of COVID-19 on TB notifications were evaluated, considering the year of 2020. The study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies [CAAE 33166620.0.0000.0102]. Results: A total of 1,509 notifications were included, with a mean incidence of 48.5/100,000 inhabitants. The median age was 42 years, most notification included males (71%), were of white race (42%) and had the pulmonary form of TB (85%). In assessing the impact of the pandemic on notifications in 2020, there was a decrease of 36% in the number of TB notifications, with an emphasis between July and August, which was the peak period of COVID-19 cases in the region. No change in the completeness of TB notifications was observed in this period. Conclusions: Results indicate the clinical and epidemiological profile in a region of SP between 2010 and 2020. The pandemic led to a decrease in the number of TB notifications but did not change the completeness of notifications.

Highlights

Tuberculosis (TB), caused by Mycobacterium tuberculosis, is considered one of the oldest infectious diseases of humanity
After applying the eligibility criteria, which excluded 114 children under 18 years of age and two notifications without date of birth, TB notifications were obtained from 1,509 patients, who were included in the study and had their data extracted
In this study, it was possible to assess the clinical and epidemiological profiles of approximately 1,500 adults diagnosed with TB in a region of São Paulo (SP), Brazil, and the significant impact of the COVID-19 pandemic on TB notifications

Summary

Introduction

Tuberculosis (TB), caused by Mycobacterium tuberculosis, is considered one of the oldest infectious diseases of humanity. In 2018, there were an estimated 10 million new cases of TB worldwide, and 1.5 million people died from the disease. In Brazil, the incidence of TB was 45 cases per 100,000 inhabitants, and the disease-related mortality rate was 2.3 deaths per 100,000 inhabitants[1]. TB is a mandatory notification disease through the information system called Sistema de Informação de Agravos de Notificação (Sinan-TB)[3]. In Brazil, approximately 80,000 new cases of TB are reported; in 2019, there were 73,864 incident cases[4] and, about 4,500 deaths from the disease, with a mortality rate of 2.2 deaths per 100,000 inhabitants. In 2020, Brazil registered 66,819 new cases of TB, with an incidence rate of 31.6 cases per 100,000 inhabitants[5]

Methods

Results

Conclusion