Spatial distribution of tuberculosis in indigenous and non-indigenous populations in the state of Pará, Brazil, 2005-2013

Abstract

Distribuição espacial de tuberculose nas populações indígenas e não indígenas do estado doCenters in Pará. The tuberculosis incidence rates were calculated for indigenous and non-indigenous populations in the 13 regions and maps were prepared to visualize the magnitude of the occurrence of tuberculosis. Results: Significant differences in the incidence of tuberculosis were found among non-indigenous and indigenous populations, reaching 7,812/100,000 inhabitants and 118/100,000 inhabitants respectively. Conclusion: Tuberculosis was distributed heterogeneously among the indigenous and non-indigenous populations. Moreover, it was possible to identify areas with high risk for this disease. It is important to note that knowledge about priority areas for tuberculosis control can help health service management to improve indicators that assess this disease and to develop different policies for indigenous peoples.Keywords: Tuberculosis; Indigenous Population; Spatial Analysis. Método: Estudio ecológico partir de datos del SINAN, estratificado para los 13 Centros Regionales de Salud existentes en Pará.Se calcularon las tasas de incidencia de tuberculosis en indígenas y no indígenas en las 13 regiones, y se confeccionaron los mapas para visualizar la magnitud de la incidencia de la tuberculosis. Resultados: Se encontró diferencias significativas en la incidencia de la tuberculosis entre la población no indígena y indígena, llegando a 7.812/100 mil habitantes y 118/100 mil habitantes. Conclusión: Se observó que la tuberculosis presenta una distribución heterogénea entre la población indígena y no indígena, y se pudo identificar las zonas con alto riesgo de la enfermedad. Es importante tener en cuenta que el conocimiento de las áreas prioritarias para el control de la tuberculosis puede ayudar a la gestión de los servicios de salud, para mejorar los índices que evalúan la enfermedad y desarrollar diferentes políticas para los pueblos indígenas.

Geospatialization of tuberculosis and income transfer programs among Indigenous peoples in an endemic territory

“…A study conducted in this mesoregion, from 2013 to 2018, considering the general population, identified TB incidence ranging from 55.07/100 thousand inhabitants and 32/100 thousand inhabitants, thus, below the rate in Indigenous ( 24 ) . This data confirms the difference in the behavior of the disease between Indigenous and non-Indigenous peoples and strengthens the need to conduct studies with this group ( 4 ) .…”

“…Although the WHO report and the Ministry of Health indicate a reduction in the incidence of TB in the general population since 2000, this rate among Indigenous people has remained stable in most Brazilian regions. Study ( 4 ) conducted with Indigenous populations of Pará from 2005 to 2013 identified an incidence coefficient of 115.16/100 thousand inhabitants, a rate higher than the national average and the average of the State of Pará ( 6 , 8 ) .…”

“…In 2020, the State of Pará (PA) registered 3,735 new cases, which correspond to the incidence coefficient of 43 cases/100 thousand inhabitants; and 255 deaths, whose mortality rate was 3 cases/100 thousand inhabitants ( 8 ) . Contributing to these indices are populations more vulnerable to illness, such as Indigenous peoples, who in 2020 had an incidence coefficient of 150.9 cases/100 thousand inhabitants ( 8 - 9 ) , strengthening the thesis of the relationship between TB and social vulnerability ( 3 - 4 , 10 ) .…”

“…From the perspective of Epidemiology, TB is influenced by population groups that have a higher risk of evolving from infection to active TB, called “special populations,” namely: immigrants; people living with the human immunodeficiency virus (HIV); people deprived of liberty; homeless population; Indigenous peoples; health professionals; users of alcohol and other drugs; smokers, and people with diabetes mellitus ( 3 ) . This characterization was due to the unfavorable evidence in health and socioeconomic indicators in these population segments ( 4 ) .…”

“…Even though the disease has been decreasing in the country, knowledge about the evolution of the epidemic and the reduction of morbimortality is necessary for the Indigenous population ( 4 ) . Therefore, the incorporation of spatial analysis techniques stands out as a tool to measure the spatial dependence of TB cases, using the Geographic Information System (GIS) and remote sensing ( 16 ) .…”