Tuberculosis and malaria walk side by side in the Brazilian Amazon: an ecological approach
Rahyja Teixeira1, Maria Gabriela Almeida Rodrigues1, Marcia Danielle Ferreira1,2
1Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.
Objective:
To assess the spatial distribution of TB and malaria incidence, as well as their spatial association with each other, regardless of environmental and socio-economic factors commonly reported as determinants of both disease rates among the municipalities of Amazonas State, Brazil between 2012 and 2015.
Methods:
Through an ecological approach considering municipalities of Amazonas, Brazil, as unit of analysis, a negative binomial regression model was used to assess association between malaria and TB rates, in which the dependent variable was the average municipal tuberculosis incidence rate.
Results:
Positive associations of overall malaria (β = 0.100 [CI = 0.032, 0.168], P = 0.004), P. vivax malaria (β = 0.115 [CI = 0.036, 0.195], P = 0.005), and P. falciparum malaria (β = 0.389 [CI = -0.0124, 0.791], P = 0.057) with TB rates were found, regardless of the sociodemographic factors included in the study.
Conclusion:
In the Brazilian Amazon, TB and malaria are spatially associated. Therefore, it is very likely that co-infections also occur in this region, regardless of the HIV status.
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