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Martins-Melo FR, Bezerra JMT, Barbosa DS, Carneiro M, Andrade KB, Ribeiro ALP, Naghavi M, Werneck GL. The burden of tuberculosis and attributable risk factors in Brazil, 1990-2017: results from the Global Burden of Disease Study 2017. Popul Health Metr 2020; 18:10. [PMID: 32993691 PMCID: PMC7526097 DOI: 10.1186/s12963-020-00203-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/19/2020] [Indexed: 01/29/2023] Open
Abstract
Background Tuberculosis (TB) continues to be an important cause of fatal and non-fatal burden in Brazil. In this study, we present estimates for TB burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017). Methods This descriptive study used GBD 2017 findings to report years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of TB in Brazil by sex, age group, HIV status, and Brazilian states, from 1990 to 2017. We also present the TB burden attributable to independent risk factors such as smoking, alcohol use, and diabetes. Results are reported in absolute number and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UIs). Results In 2017, the number of DALYs due to TB (HIV-negative and HIV-positive combined) in Brazil was 284,323 (95% UI: 240,269–349,265). Among HIV-negative individuals, the number of DALYs was 196,366 (95% UI: 189,645–202,394), while 87,957 DALYs (95% UI: 50,624–146,870) were estimated among HIV-positive individuals. Between 1990 and 2017, the absolute number and age-standardized rates of DALYs due to TB at the national level decreased by 47.0% and 68.5%, respectively. In 2017, the sex–age-specific TB burden was highest among males and in children under-1 year and the age groups 45–59 years. The Brazilian states with the highest age-standardized DALY rates in 2017 were Rio de Janeiro, Pernambuco, and Amazonas. Age-standardized DALY rates decreased for all 27 Brazilian states between 1990 and 2017. Alcohol use accounted for 47.5% of national DALYs due to TB among HIV-negative individuals in 2017, smoking for 17.9%, and diabetes for 7.7%. Conclusions GBD 2017 results show that, despite the remarkable progress in reducing the DALY rates during the period, TB remains as an important and preventable cause of health lost to due premature death and disability in Brazil. The findings reinforce the importance of strengthening TB control strategies in Brazil through integrated and multisectoral actions that enable the access to prevention, early diagnosis, and timely treatment, with emphasis on high-risk groups and populations most vulnerable to the disease in the country.
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Affiliation(s)
- Francisco Rogerlândio Martins-Melo
- Federal Institute of Education, Science and Technology of Ceará, Rua Francisco da Rocha Martins, S/N, Pabussu, Caucaia, CE, 61609-090, Brazil.
| | - Juliana Maria Trindade Bezerra
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - David Soeiro Barbosa
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Mariângela Carneiro
- Epidemiology of Infectious and Parasitic Diseases Laboratory, Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Kleydson Bonfim Andrade
- National Tuberculosis Programme, Department of Chronic Infectious Diseases and STI, Secretariat of Health Surveillance, Brazilian Ministry of Health, SRTVN, Quadra 701, Via W5 Norte, Lote D, Edifício PO700, 6° andar, Brasília, DF, Brazil
| | - Antonio Luiz Pinho Ribeiro
- Hospital das Clínicas, Faculty of Medicine, Federal University of Minas Gerais, Avenida Prof. Alfredo Balena, 110, Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Avenue, Suite 600, Seattle, WA, 98121, USA
| | - Guilherme Loureiro Werneck
- Institute of Studies in Public Health, Federal University of Rio de Janeiro, Avenida Horácio Macedo, S/N, Ilha do Fundão - Cidade Universitária, Rio de Janeiro, RJ, 21941-598, Brazil.,Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Oliveira SPD, Silveira JTPD, Beraldi-Magalhães F, Oliveira RRD, Andrade LD, Cardoso RF. Early death by tuberculosis as the underlying cause in a state of Southern Brazil: Profile, comorbidities and associated vulnerabilities. Int J Infect Dis 2019; 80S:S50-S57. [PMID: 30826483 DOI: 10.1016/j.ijid.2019.02.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/26/2019] [Accepted: 02/26/2019] [Indexed: 10/27/2022] Open
Abstract
AIM To know the profile of adults who died by tuberculosis as the main cause, the time interval between the diagnosis and death, associated comorbidities and vulnerabilities. METHOD Observational study of secondary data regarding deaths by tuberculosis that occurred in the State of Paraná, Brazil, from 2008 to 2015. A linkage between the databases of mortality and tuberculosis notification system was conducted for data enrichment. Frequency tables, Exact Fisher test and Z test have identified statistical associations. RESULTS Linkage points out 12.1% (115/944) of under-reporting in the 944 deaths identified. Early deaths accounted for 74.6% (705/944). The male sex (75.8%) was associated with the early death group. Almost half of the deaths reported in notification system (414/829) had one or more vulnerabilities. Early death were associated with respiratory system diseases and symptoms (p=0.0001) and mental and behavioral disorders (p=0.0001). CONCLUSION High number of early deaths due TB indicate the need to seek out the respiratory symptomatic and use faster diagnostic methods. Strategies for treatment adherence, adequate monitoring of comorbidities and multisectorial support may prevent early and late death. The presence of vulnerabilities indicates that efforts beyond the health sector are needed in order to eliminate tuberculosis as public health problem.
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Affiliation(s)
- Simoni Pimenta de Oliveira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Paraná, Brazil; Secretaria de Estado da Saúde do Paraná, Brazil.
| | | | - Francisco Beraldi-Magalhães
- Secretaria de Estado da Saúde do Paraná, Brazil; Programa de Pós Graduação em Medicina Tropical, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado / Universidade do Estado do Amazonas, Amazonas, Brazil
| | | | - Luciano de Andrade
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Paraná, Brazil
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Maciel EL, Braga JU, Bertolde AI, Zandonade E. Reflections upon the article "Evaluation of the impact that the changes in tuberculosis treatment implemented in Brazil in 2009 have had on disease control in the country"Authors' replyEvaluation of the impact that the changes in tuberculosis treatment implemented in Brazil in 2009 have had on disease control in the countryHow Do You Know Which Health Care Effectiveness Research You Can Trust A Guide to Study Design for the PerplexedSegmented regression analysis of interrupted time series studies in medication use researchConducting interrupted time series analysis for single-and multiple-group comparisonsInterrupted time series regression for the evaluation of public health interventions a tutorialHow to obtain the confidence interval from a P value. ACTA ACUST UNITED AC 2019; 44:249-252. [PMID: 30043894 PMCID: PMC6188688 DOI: 10.1590/s1806-37562018000000096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Ethel Leonor Maciel
- . Laboratório de Epidemiologia, Universidade Federal do Espírito Santo, Vitória (ES) Brasil
| | - José Ueleres Braga
- . Departamento de Epidemiologia e Métodos Quantitativos, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro (RJ) Brasil.,. Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Adelmo Inácio Bertolde
- . Departamento de Estatística, Universidade Federal do Espírito Santo, Vitória (ES) Brasil
| | - Eliana Zandonade
- . Departamento de Estatística, Universidade Federal do Espírito Santo, Vitória (ES) Brasil
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