Abstract
The objective was to analyze the temporal trend of tuberculosis incidence rates in Brazilian states and regions to identify patterns and inequalities. We carried out an ecological study of incidence rates per 100,000 inhabitants aged between 20 and 59 years with tuberculosis in Brazil and in their respective states from 2001 to 2017 according to annual percentage change and joinpoint regression. A significant decrease of -15.1% in the annual variation (95%CI: -27.2; -1.0) was observed in Roraima between the years 2003-2007. In the Central Region, Goiás registered an annual average variation of -2.5% per year (95%CI: -3.6; -1.3). Five out of nine Northeastern states had decreasing annual variations throughout the studied series. Espírito Santo and Rio de Janeiro were the states of the Southeast that presented decreasing between 2001-2017. In the Southern Region, the state of Paraná was the only one with the same annual variation of -3.7% (95%CI: -4.1; -3.2). In Brazil, the average annual percentage change was -1.8% (95%CI: -2.4; -1.1). The results of this study showed a decline in the incidence of tuberculosis in Brazil. However, regional and intra-regional differences were observed. Determining the trend pattern of tuberculosis incidence may assist in the planning and implementation of national tuberculosis control policies.
Highlights
Global confrontation of tuberculosis (TB) requires progress in prevention and care of patients in countries with high incidence, including Brazil
We observed a decrease in incidence in all regions in the period, high incidences of disease were recorded in the first years of the time series (Figure 1)
Incidence coefficients associated with the number of tuberculosis cases confirmed in individuals between 20 and 59 years of age, according to State, Brazil, 2001 to 2017
Summary
Global confrontation of tuberculosis (TB) requires progress in prevention and care of patients in countries with high incidence, including Brazil. In the Americas, Brazil has a significant role in the fight against tuberculosis, it presents characteristics common to the region, such as high levels of urbanization, social inequalities, and ethnic and cultural diversity. Other characteristics may help in understanding the Brazilian response capacity, among them: having the second largest Gross Domestic Product (GDP) among the countries of the Americas; ranking 15th in Human Development Index (HDI) among American countries, 5th in the list of countries with the highest income per capita in South America, and 6th in life expectancy, among Latin American countries 2. Since 2003, TB has been considered a priority disease in the political agenda of the Ministry of Health, as Brazil is one of the countries with the highest number of cases in the world. About 69,000 new cases of tuberculosis and 4,500 deaths were reported in 2016 2
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