Tuberculosis in Brazil: one country, multiple realities.

Autor:	Cortez AO; Programa de Pós-Graduação em Ciências da Saúde, Grupo de Pesquisa em Tuberculose e Doenças Infecciosas, Universidade Federal de São João del-Rei, Divinópolis (MG) Brasil., Melo AC; Programa de Pós-Graduação em Ciências da Saúde, Grupo de Pesquisa em Tuberculose e Doenças Infecciosas, Universidade Federal de São João del-Rei, Divinópolis (MG) Brasil.; Programa de Pós-Graduação em Ciências Farmacêuticas, Grupo de Pesquisa em Farmácia Clínica, Assistência Farmacêutica e Saúde Coletiva, Universidade Federal de São João del-Rei, Divinópolis (MG) Brasil., Neves LO; Grupo de Pesquisa em Micrometeorologia de Ecossistemas, Instituto Federal Catarinense, Rio do Sul (SC) Brasil., Resende KA; Programa de Pós-Graduação em Ciências Farmacêuticas, Grupo de Pesquisa em Farmácia Clínica, Assistência Farmacêutica e Saúde Coletiva, Universidade Federal de São João del-Rei, Divinópolis (MG) Brasil., Camargos P; Programa de Pós-Graduação em Ciências da Saúde, Grupo de Pesquisa em Tuberculose e Doenças Infecciosas, Universidade Federal de São João del-Rei, Divinópolis (MG) Brasil.
Jazyk:	English; Portuguese
Zdroj:	Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia [J Bras Pneumol] 2021 Feb 24; Vol. 47 (2), pp. e20200119. Date of Electronic Publication: 2021 Feb 24 (Print Publication: 2021).
DOI:	10.36416/1806-3756/e20200119
Abstrakt:	Objective: To identify the determinants of tuberculosis-related variables in the various regions of Brazil and evaluate trends in those variables over the ten-year period preceding the end of the timeframe defined for the United Nations Millennium Development Goals (MDGs). Methods: This was an ecological analytical study in which we utilized eight national public databases to investigate the 716,971 new tuberculosis cases reported between 2006 and 2015. Results: Over the study period, there were slight reductions in the prevalence, incidence, and mortality associated with tuberculosis. Brazil did not reach the MDG for tuberculosis-related mortality. Among the performance indicators of tuberculosis control, there were improvements only in those related to treatment and treatment abandonment. In terms of the magnitude of tuberculosis, substantial regional differences were observed. The tuberculosis incidence rate was highest in the northern region, as were the annual mean temperature and relative air humidity. That region also had the second lowest human development index, primary health care (PHC) coverage, and number of hospitalizations for tuberculosis. The northeastern region had the highest PHC coverage, number of hospitalizations for primary care-sensitive conditions, and tuberculosis-related mortality rate. The southern region showed the smallest reductions in epidemiological indicators, together with the greatest increases in the frequency of treatment abandonment and retreatment. The central-west region showed the lowest overall magnitude of tuberculosis and better monitoring indicators. Conclusions: The situation related to tuberculosis differs among the five regions of Brazil. Those differences can make it difficult to control the disease in the country and could explain the fact that Brazil failed to reach the MDG for tuberculosis-related mortality. Tuberculosis control measures should be adapted to account for regional differences.
Databáze:	MEDLINE
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