Risk areas for tuberculosis among children and their inequalities in a city from Southeast Brazil

Yan Mathias Alves,Ricardo Alexandre Arcêncio,Luana Seles Alves,Marcos Augusto Moraes Arcoverde,Antonio Carlos Vieira Ramos,Ivaneliza Simionato De Assis,Juliane De Almeida Crispim,Luiz Henrique Arroyo,Thaís Zamboni Berra,Ludmilla Leidianne Limirio Souza,Laura Terenciani Campoy,Alexandre Tadashi Inomata Bruce,Felipe Lima Dos Santos

doi:10.1186/s12887-020-02364-7

Abstract

BackgroundThe objective of the study was to identify areas of risk for the appearance of tuberculosis in children and their association with social inequalities in a municipality in southeastern Brazil.MethodsEcological study conducted in Ribeirão Preto, Brazil. To identify areas of spatial risk for tuberculosis in children, we used spatial scanning statistics. To analyze the association of cases of childhood tuberculosis with social vulnerability, we used the Social Vulnerability Index of São Paulo, and four explanatory statistical models were listed.ResultsThere were 96 cases of childhood tuberculosis, of which 90 were geocoded through a process of converting addresses to geographic coordinates. A risk area was identified in the municipality, where children under 15 years old have 3.14 times greater risk of contracting tuberculosis than those living outside this area. The variables identified as risk factors were: number of private and collective households, proportion of children aged 0 to 5 years in the population, proportion of households without per capita income, and the proportion of private households with monthly nominal incomes of up to one quarter of wage minimums. The variables identified as protection factors were the proportion of women under the age of 30 years responsible for the household under and women responsible for the household with an average income over BRL 2344.ConclusionThe study showed areas of risk for the occurrence of tuberculosis in children. The study is in line with the End TB Strategy and the 2030 Agenda, which aim to support strategic actions and, therefore, save the lives of children through the systematic, intensified, and comprehensive identification of children with tuberculosis respiratory symptoms in the community.

Highlights

IntroductionDuring 2018 in Brazil, more than 73,000 new TB cases were registered, including almost 14,000 cases of TB retreatment and more than 500 cases of multidrug resistant TB [2]
The objective of the study was to identify areas of risk for the appearance of tuberculosis in children and their association with social inequalities in a municipality in southeastern Brazil
There were 98 cases of TB reported in children in the municipality between 2006 and 2017; the children were between 2 months and 14 years old, with a mean age of 8 years and median of 9 years

Summary

Introduction

During 2018 in Brazil, more than 73,000 new TB cases were registered, including almost 14,000 cases of TB retreatment and more than 500 cases of multidrug resistant TB [2]. In addition to these alarming data, TB is responsible for 130,000 deaths per year in children, and it is estimated that there are approximately 1 million cases of TB in the world’s child population (about 11,000 cases in Brazil), which means that TB ranks as one of the top 10 causes of death in children worldwide [2]. The confirmation of the disease in the pediatric age group is often a sentinel event that signals the presence of an adult with TB in the child’s household [3]

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