Time trend, social vulnerability, and identification of risk areas for tuberculosis in Brazil: An ecological study

Spatial patterns and factors associated with the incidenceof tuberculosis-diabetes in Brazil

OBJECTIVES

The aim of this study was to analyse the spatial patterns and factors associated with the incidence of tuberculosis-diabetes (TB-DM) in Brazil, from 2001 to 2019.

STUDY DESIGN

Ecological study.

METHODS

Brazilian municipalities were used as the units of analysis. The local empirical Bayesian rate and the spatial autocorrelation test were calculated. Moran and Getis-Ord Gi∗ were used to identify spatial clusters, and spatially weighted regression was conducted.

RESULTS

In total, 75,021 new cases of TB associated with DM were reported in Brazil during the study period. Most Brazilian municipalities had an average TB-DM incidence of 1.0-2.0/100,000 inhabitants. The regression showed that the Gini index (β = 0.85) and family health strategy coverage (β = -0.26) were the two indicators that had the most influence on TB-DM incidence in Brazil.

CONCLUSIONS

This study identified spatial clusters of TB-DM in Brazil. The results also indicated that social inequalities played a key role in the incidence of TB.

Influential Factors of Tuberculosis Notification Rates in Turkey: A Provincial-Level Spatial Analysis

OBJECTIVE

The total annual count of reported tuberculosis (TB) cases continues to decline throughout Turkey. Recognizing the regions with high and low burdens and revealing the factors affecting TB notification rates may play a role in guiding national control programs. This study aimed to analyze the spatial distribution of TB notification rates from 2005 to 2018 and evaluate the factors contributing to TB rates.

MATERIAL AND METHODS

In this ecological study, we used freely available open data from the Internet. We employed global and local spatial autocorrelation analysis to identify the spatial distribution and the clusters with low and high burdens. We conducted an ordinary least square regression model, spatial lag model, and spatial error model. The best-fitting model was selected via model parameters.

RESULTS

Throughout the study period, the provinces in West Marmara Region (Edirne, Kırklareli, Tekirdağ, Çanakkale) were consistently in a high-burden cluster. In univariate ordinary least square regression, population density, the proportion of contacts screened for TB, the proportion of TB contacts who received prophylaxis, TB dispensary count, mean particulate matter 10 levels, and gross domestic product were found to be positively associated with TB notification rate. The best-fitting multivariate spatial lag model revealed that the proportion of contacts screened for TB (β, z-value: 0.89, 2.21) positively affected TB notification rate.

CONCLUSION

The high TB burden in West Marmara Region should warn policymakers to maintain a focused approach to controlling TB in this area. This study showed the importance of contact tracing efforts to prevent the underdetection of TB cases.

An investigation of the effects of meteorological factors on the incidence of tuberculosis

To explore the influence of meteorological factors on the incidence of tuberculosis (TB) in Yingjisha County, Kashgar Region, Xinjiang, and to provide a scientific basis for the prevention and control of TB. The Spearman correlation analysis and distribution lag nonlinear model analysis were conducted on the number of daily reported cases of TB from 2016 to 2023 to study the association effect of various meteorological factors and the daily incidence number of TB in Yingjisha County. A total of 13,288 TB cases were reported from January 2016 to June 2023, and June to October is the peak period of annual TB incidence. Spearman correlation analysis revealed that average daily temperature (AT) and average daily wind speed (WS) were positively correlated with TB incidence (rAT = 0.110, rWS = 0.090); and average daily relative humidity (RH) and TB incidence was negatively correlated (rRH = - 0.093). When AT was - 15 °C, the RR reached a maximum of 2.20 (95% CI: 0.77-6.29) at a lag of 21 days. When RH was 92%, the RR reached a maximum of 1.05 (95% CI: 0.92-1.19) at a lag of 6 days. When WS was 5.2 m/s, the RR reached a maximum of 1.30 (95% CI: 0.78-2.16) at a lag of 16 days. There is a non-linearity and a certain lag between meteorological factors and the occurrence and prevalence of TB in the population, which is mainly manifested in the fact that the risk of incidence of TB decreases with the increase of the daily AT, has a hazardous effect within a certain range of humidity as the average daily RH rises, and gradually increases with the increase of the average daily WS. Local residents are advised to pay attention to climate change so as to take appropriate preventive measures, especially women and middle and old age group should pay close attention to climate change and add more clothes in time, minimise travelling in hazy weather and windy and sandy weather, maintain good nutrition, adequate sleep and moderate exercise in daily life to enhance their immunity, wash hands frequently and ventilate the air, and try to avoid staying in humid and confined spaces in order to reduce the risk of latent TB patients developing the disease.

Burden of tuberculosis among vulnerable populations worldwide: an overview of systematic reviews

BACKGROUND

Tuberculosis is a communicable disease of public health concern that inequitably impacts the most vulnerable populations worldwide. Vulnerable populations are those with a high risk for tuberculosis disease and whose disadvantaged or marginalised socioeconomic position limits their access to the health system. We conducted an overview of reviews that aimed to assess the burden (ie, prevalence and incidence) of tuberculosis disease among 12 vulnerable populations globally.

METHODS

We did an overview of reviews using a systematic search in MEDLINE, Embase, and the Cochrane Database for Systematic Reviews for articles published in English, French, and Chinese, from Jan 1, 2010 to March 8, 2023. We did an initial search on Oct 28, 2021, and updated our search on March 8, 2023. We included systematic and scoping reviews reporting on the prevalence or incidence of active tuberculosis among 12 vulnerable populations. Evidence gaps were supplemented with primary or secondary database studies. Study characteristics and outcome data related to tuberculosis burden were tabulated, including prevalence ratios and incidence rate ratios, and evidence was synthesised narratively. This trial is registered with PROSPERO (CRD42022324421).

FINDINGS

We screened 13 169 citations and included 44 publications (23 reviews and 21 primary or database studies) in the final synthesis. The comprehensiveness and methodological quality of the evidence differed across population groups. Prevalence of more than 1000 cases per 100 000 were reported in all vulnerable populations. On the basis of pooled estimates, prevalence ratios were often more than 25 among people experiencing homelessness, incarcerated populations, refugees, asylum seekers, and people living with HIV compared with the general population. Incidence was infrequently reported, with the best-available incidence rate ratios documented for people who were incarcerated. There was scarce evidence specific to miners, nomadic populations, sex workers, men who have sex with men, and transgender individuals.

INTERPRETATION

The burden of tuberculosis is substantially higher among vulnerable populations than general populations, suggesting a need for improved integration of these groups, including dedicated efforts for their identification, targeted screening and prevention measures, as well as treatment support.

FUNDING

WHO.

Educational technology on tuberculosis: construction shared with Primary Health Care nurses

OBJECTIVE

to develop, in a participatory way, an educational technology to assist nurses in the management of tuberculosis cases in Primary Health Care.

METHODS

methodological research with a qualitative approach. Data were collected between June and October 2022, in 25 Basic Health Units, with 41 nurses interviewed individually. Thematic content analysis was carried out to guide technology elaboration.

RESULTS

three empirical categories were organized, demonstrating the facilities and difficulties in tuberculosis management, the conceptions about educational technology as a facilitator of the teaching-learning process in Primary Health Care and participatory development of technology. Nurses were in favor of constructing an instructional guide technology, and made suggestions to encourage its creation and use in daily service routine.

FINAL CONSIDERATIONS

the participatory process made it possible to create technology to assist nurses in the teaching-learning process in Primary Health Care about caring for people with tuberculosis.

Geo-spatial high-risk clusters of Tuberculosis in the global general population: a systematic review

INTRODUCTION

The objective of this systematic review is to identify tuberculosis (TB) high-risk among the general population globally. The review was conducted using the following steps: elaboration of the research question, search for relevant publications, selection of studies found, data extraction, analysis, and evidence synthesis.

METHODS

The studies included were those published in English, from original research, presented findings relevant to tuberculosis high-risk across the globe, published between 2017 and 2023, and were based on geospatial analysis of TB. Two reviewers independently selected the articles and were blinded to each other`s comments. The resultant disagreement was resolved by a third blinded reviewer. For bibliographic search, controlled and free vocabularies that address the question to be investigated were used. The searches were carried out on PubMed, LILACS, EMBASE, Scopus, and Web of Science. and Google Scholar.

RESULTS

A total of 79 published articles with a 40-year study period between 1982 and 2022 were evaluated. Based on the 79 studies, more than 40% of all countries that have carried out geospatial analysis of TB were from Asia, followed by South America with 23%, Africa had about 15%, and others with 2% and 1%. Various maps were used in the various studies and the most used is the thematic map (32%), rate map (26%), map of temporal tendency (20%), and others like the kernel density map (6%). The characteristics of the high-risk and the factors that affect the hotspot's location are evident through studies related to poor socioeconomic conditions constituting (39%), followed by high population density (17%), climate-related clustering (15%), high-risk spread to neighbouring cities (13%), unstable and non-random cluster (11%).

CONCLUSION

There exist specific high-risk for TB which are areas that are related to low socioeconomic conditions and spectacular weather conditions, these areas when well-known will be easy targets for intervention by policymakers. We recommend that more studies making use of spatial, temporal, and spatiotemporal analysis be carried out to point out territories and populations that are vulnerable to TB.

Tuberculosis Disability Adjusted Life Years, Colombia 2010-2018

Estimating the burden of tuberculosis disease is relevant for assessing and identifying population health status and progress in policies and programs aimed at epidemic control. The objective of this study was to estimate disability-adjusted life years attributable to Tuberculosis in Colombia 2010-2018. A longitudinal descriptive study was conducted. The variables, sex, age groups and origin were studied. This study included 110,475 cases of morbidity and 8514 cases of mortality. Indicators of years of life lost, years of life with disability and disability-adjusted life years at the subnational level were determined using the methodology of the World Health Organization. With the results of this last indicator, an epidemiological risk stratification was carried out. The DALY rate of the study period was 684 (95% CI 581.2-809.1) per 100,000 inhabitants. According to sex, 68.4% occurred in men; for every DALY in women, 2.21 occur in men. People of productive age (15 to 69 years) account for 56% of DALYs. Amazonas (1857.1 CI 95% 1177.1-2389.6) was the territorial entity with the highest rate. A total of 51.5% of the territorial entities of departmental order of the country are of high burden for Tuberculosis. For the first time in Colombia, a comprehensive assessment of the status of the disease burden at a subnational (departmental) territorial level attributable to Tuberculosis is being carried out using the updated World Health Organization methodology. The results obtained allow us to specify that there is a knowledge gap in terms of the realization and clear understanding of the burden of the disease in Colombia. There are territorial gaps that are necessary to know in order to plan, develop, implement and redirect policies to improve health and eliminate disparities according to the territorial context.