Perfil dos municípios brasileiros, a presença de tuberculosee sua forma drogarresistente

Abstract

Resumo A tuberculose tem estreita relação com as condições de vida das pessoas. O presente estudo classifica os municípios brasileiros de acordo com a presença ou ausência de casos de tuberculose (TB) e sua forma drogarresistente (TB-DR), e os descreve quanto às condições de saúde da população, os indicadores de controle da tuberculose, perfil demográfico e socioeconômico. Em 2014, 327 municípios registraram casos de TB-DR. Regiões integradas de desenvolvimento ou regiões metropolitanas concentraram 80,1% dos casos de TB-DR do País. Os municípios com casos de TB-DR tiveram piores indicadores de desfecho da TB, mas maiores percentuais de realização de exame de cultura, além de mais habitantes e melhores indicadores socioeconômicos. Os 3.644 municípios com casos de TB, mas sem casos de TB-DR, tiveram os piores indicadores socioeconômicos entre os três grupos. Os 1.594 municípios sem casos de TB tiveram as menores taxas de desemprego e de detecção de AIDS, e maior cobertura de atenção básica. Os diferentes perfis encontrados no estudo podem dar suporte à lapidação de estratégias nacionais de controle da doença e sua forma drogarresistente no País.

Spatial patterns of multidrug-resistant tuberculosis: correlation with sociodemographic variables and type of notification

“…Such findings were found in other studies in which TB is related to poor indicators, such as: low household income; low HDI; low per capita income; low life expectancy at birth; and high unemployment rates. All of this strengthens the thesis that TB is related to social inequality (18,23) .…”

“…In addition, there is evidence that municipalities with cases of MDR-TB have less primary care coverage and adherence to DOT, confirming the need for greater attention by health professionals, in the monitoring and control of patients, since DOT is a fundamental strategy for achieving cure, as it promotes adequate intake of anti-TB drugs, when accompanied by trained professionals (23) .…”

Effect of income on the cumulative incidence of COVID-19: an ecological study

“…Relating income with the incidence of infectious diseases is not new, as this relationship has been reported by other studies addressing infectious diseases (7)(8)(9)20) . Since the beginning of the pandemic, health authorities have expressed concern with the behavior of the epidemic in the world's most impoverished regions (6,(21)(22) .…”

“…From what is known about the social structures in the city of Rio de Janeiro, considering a higher population density on the outskirts and more impoverished neighborhoods, the natural hypothesis is that these regions would experience a greater spread of the disease, as it occurs in the epidemiological chain of other respiratory diseases (7,9,20) . Nonetheless, the practical effect of these findings gains strength in the observation that the wealthiest regions such as Lagoa, Tijuca and Copacabana, present high cumulative incidence rates, occupying the first of the five ranks of per capita income.…”

“…The reason is that accumulated theoretical knowledge regarding infectious diseases indicates that there is a potential relationship between per capita income and the incidence of the disease; its spread dynamics are different in European and North American regions, where a significant portion of studies addressing COVID-19 originated (6) . Studies addressing HIV, tuberculosis, and leprosy have already reported this relationship so that it remains to be known how this variable behaves in the case of the COVID-19 pandemic, a critical gap so far (7)(8)(9) .…”