Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012

Gaspar, Renato Simões; Nunes, Natália; Nunes, Marina; Rodrigues, Vandilson Pinheiro

doi:10.1590/S1806-37562016000000054

Acessibilidade / Reportar erro

Brasil

Jornal Brasileiro de Pneumologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • J. bras. pneumol. 42 (06) • Nov-Dec 2016 • https://doi.org/10.1590/S1806-37562016000000054 copy

Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012^* Financial support: None.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012.

Methods:

This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection.

Results:

Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis.

Conclusions:

Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished.

Keywords:
Tuberculosis/epidemiology; HIV infections/epidemiology; Comorbidity

Year	TB		TB-HIV co-infection		TB-HIV co-infection/TB ratio, %
Year	Crude incidence	Incidence/ 100,000 population	Crude incidence	Incidence/ 100,000 population
2002	77,507	44.38	5,943	3.40	7.67
2003	78,599	44.44	6,068	3.43	7.72
2004	77,691	43.38	5,835	3.26	7.51
2005	76,751	41.67	5,841	3.17	7.61
2006	71,831	38.46	6,162	3.30	8.58
2007	71,629	37.83	6,398	3.38	8.93
2008	73,427	38.72	6,630	3.50	9.03
2009	72,895	38.07	6,771	3.54	9.29
2010	71,390	37.42	7,037	3.69	9.86
2011	73,168	38.03	7,150	3.72	9.77
2012	70,023	36.10	6,846	3.53	9.78
Total variation, %	−9.66	−18.66	15.19	3.82	27.51
p	< 0.05	< 0.05	< 0.05	< 0.05	< 0.05

Year	Incidence of TB/ 100,000 population		Incidence of TB-HIV co-infection/ 100,000 population
Year	Males	Females	Males	Females
2002	57.64	31.44	4.93	1.92
2003	57.69	31.58	4.92	1.99
2004	56.64	30.50	4.64	1.92
2005	54.66	29.04	4.49	1.89
2006	50.48	26.80	4.67	1.97
2007	50.33	25.75	4.84	1.97
2008	51.69	26.19	4.96	2.08
2009	50.91	25.67	5.00	2.12
2010	50.52	24.86	5.27	2.17
2011	51.58	25.04	5.34	2.16
2012	49.27	23.45	5.05	2.07
Total variation, %	−14.52	−25.41	2.43	7.81
p	< 0.05	< 0.05	< 0.05	< 0.05

Year	Incidence of TB/ 100,000 population					Incidence of TB-HIV co-infection/ 100,000 population
	Age group, years					Age group, years
	0-9	10-19	20-39	40-59	≥ 60	0-9	10-19	20-39	40-59	≥ 60
2002	6.28	18.78	102.31	70.79	29.12	0.33	0.32	11.51	5.00	0.32
2003	5.96	18.31	102.22	71.76	29.28	0.27	0.33	11.17	5.50	0.37
2004	5.40	17.43	99.96	70.77	28.43	0.33	0.37	10.32	5.36	0.38
2005	5.07	16.62	95.25	68.63	27.63	0.25	0.29	9.83	5.52	0.41
2006	4.52	13.85	87.34	65.05	25.73	0.31	0.37	9.52	6.18	0.59
2007	4.78	15.69	95.74	69.54	27.66	0.22	0.38	10.79	7.12	0.61
2008	4.45	16.16	96.73	70.37	28.14	0.22	0.47	10.74	7.10	0.68
2009	4.62	16.12	100.81	73.23	28.25	0.24	0.50	11.24	7.82	0.89
2010	4.59	17.32	100.52	74.20	32.42	0.23	0.50	11.57	8.19	0.93
2011	4.68	18.41	112.27	82.32	33.78	0.24	0.60	13.49	9.54	0.90
2012	4.32	17.40	106.12	78.34	31.37	0.21	0.49	12.80	8.83	0.99
Total variation, %	−31.21	−7.35	3.72	10.67	7.73	−36.36	53.13	11.21	76.60	209.38
p	< 0.05	0.73	0.24	< 0.05	0.06	< 0.05	< 0.05	0.05	< 0.05	< 0.05

Year	Incidence of TB/ 100,000 population					Incidence of TB-HIV co-infection/ 100,000 population
Year	N	NE	SE	S	CW	N	NE	SE	S	CW
2002	51.03	44.15	48.73	34.64	26.29	1.39	0.94	4.8	5.42	1.49
2003	49.97	46.14	47.27	35.41	27.08	1.96	1.28	4.55	5.41	1.58
2004	50.6	45.9	45.52	34.08	24.7	1.64	1.48	4.21	5.04	1.49
2005	47.32	45.54	42.9	32.32	25.34	1.95	1.46	3.95	5.03	1.68
2006	46.05	41.03	40.53	30.48	24.27	1.96	1.56	4.47	4.69	1.67
2007	45.01	39.49	40.68	31.83	23.13	2.27	1.88	4.14	5.23	2.08
2008	44.69	38.13	40.37	31.84	22.8	3.18	2.05	4.01	5.71	1.97
2009	47.78	38.85	41.01	33.21	21.91	3.41	2.19	4.00	5.58	2.06
2010	40.88	33.95	36.45	30.35	20.98	3.83	2.48	3.93	6.08	2.03
2011	46.42	37.7	41.48	33.26	23.08	3.67	2.64	3.97	5.92	2.04
2012	44.72	35.26	38.89	32.06	24.24	3.81	2.7	3.59	5.48	2.19
Total variation, %	−12.37	−20.14	−20.19	−7.45	−7.80	174.10	187.23	−25.21	1.11	46.98
p	< 0.05	< 0.05	< 0.05	0.08	< 0.05	< 0.05	< 0.05	< 0.05	0.07	< 0.05

Outcome	Cases reported to SINAN, %		OR (CI 95%)	p
Outcome	TB-HIV co-infection	TB^a
Cure
Yes	50.74	71.10	0.42 (0.41-0.42)	< 0.05
No	49.26	28.90	Ref.
Nonadherence
Yes	13.60	9.52	1.50 (1.46-1.53)	< 0.05
No	86.40	90.48	Ref.
Death from TB
Yes	3.63	1.90	1.94 (1.86-2.02)	< 0.05
No	96.37	98.10	Ref.
Multidrug-resistant TB
Yes	0.17	0.17	0.95 (0.75-1.21)	0.70
No	99.83	99.83	Ref.

Sociedade Brasileira de Pneumologia e Tisiologia SCS Quadra 1, Bl. K salas 203/204, 70398-900 - Brasília - DF - Brasil, Fone/Fax: 0800 61 6218 ramal 211, (55 61)3245-1030/6218 ramal 211 - São Paulo - SP - Brazil
E-mail: jbp@sbpt.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence to: Vandilson Pinheiro Rodrigues. Departamento de Morfologia, Universidade Federal do Maranhão, Avenida dos Portugueses, S/N, Campus Universitário do Bacanga, CEP 65085-580, São Luís, MA, Brasil. Tel.: 55 98 98141-5836. E-mail: vandilson@hotmail.com

Brasil

Brasil

Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012* Financial support: None.

ABSTRACT

Objective:

Methods:

Results:

Conclusions:

Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012^* Financial support: None.