Abstract
ABSTRACT: Objective: To analyze the tuberculosis spatial pattern and its relationship with socioeconomic indicators, from 2008 to 2015, in a priority city for tuberculosis control by the National Tuberculosis Control Program, Juiz de Fora, Minas Gerais. Methods: Ecological study in which the units of analysis were 81 urban regions of Juiz de Fora. Secondary data from Notifiable Diseases Information System and 2010 Demographic Census were used. Georeferenced data from 1,854 notifications were used to elaborate thematic maps in order to verify the distribution pattern of average tuberculosis rates and socioeconomic indicators within the city. Global spatial autocorrelation (Moran's I) and local (Local Indicator of Spatial Association) and multiple linear regression model were estimated to analyze the relationship between the average tuberculosis incidence rate and socioeconomic indicators. Results: The average tuberculosis incidence rate was 48.3 cases/100,000 inhabitants/year. It was found that the urban regions corresponding to central regions of the city had lower rates with a progressive increase toward the urban regions representative of the most peripheral neighborhoods. All variables showed significant spatial autocorrelation. The regression model showed an association between the average tuberculosis incidence rate and the proportion of poor, household density, and aging index. Conclusion: The dynamics of tuberculosis transmission in Juiz de Fora may be explained by the maintenance of social inequality and urban space organization process.
Highlights
Tuberculosis (TB) persists as an important and challenging public health problem
The urban regions (UR) corresponding to the Central Administrative Region of the municipality had lower IRm, with a progressive increase toward those representative of the most peripheral neighborhoods
This study showed that the distribution of TB cases in the city of Juiz de Fora is not uniform
Summary
Tuberculosis (TB) persists as an important and challenging public health problem It is the result of social inequities in health and contributes to the maintenance of inequality and social exclusion in several countries. It is one of the most prevalent diseases among people living in poverty in the world, with a high mortality burden, along with the human immunodeficiency virus (HIV) and malaria[1]. In the last ten years, an average of 71,000 new TB cases per year have been diagnosed in the country[1] It is a disease of multicausal manifestation, being dependent on the characteristics inherent to the microorganism, on the host’s immune response, and on the conditions to which individuals are exposed throughout life[2]. The marked influence of living conditions on illness from TB is well known; demographic, social, and economic factors, such as income inequality, precarious housing, overcrowding, food insecurity, low education, and barriers to access health services, contribute to the maintenance and spread of the disease[1,3,4]
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