From Patterns to Projections: A Spatiotemporal Distribution of Drug-Resistant Tuberculosis in Paraná, Brazil...

Area of Science:

• Epidemiology
• Public Health
• Infectious Disease Dynamics

Background:

• Drug-resistant tuberculosis (DR-TB) poses a significant global health threat due to its high transmissibility.
• Understanding the epidemiological patterns of DR-TB is crucial for effective control strategies.

Purpose of the Study:

• To analyze the prevalence, incidence, and spatiotemporal patterns of drug-resistant tuberculosis in Paraná, Brazil, from 2012 to 2023.
• To forecast future trends of DR-TB incidence through 2030.

Main Methods:

• Ecological study utilizing national surveillance data.
• Employed descriptive statistics, Mann-Kendall trend tests, spatial analysis (Moran's I, spatial scan statistic), and time series forecasting (SARIMA).

Main Results:

• Identified 576 DR-TB cases with an overall incidence of 5.08 per 100,000, showing a significant increasing trend (p < 0.001).
• Isoniazid monoresistance was the most common resistance profile. Higher prevalence observed in males, young adults (15-34 years), and among Asian and Black populations.
• Spatial analysis revealed expansion over time, with persistent high-risk clusters identified in the North and Northwest regions.

Conclusions:

• The study indicates a concerning rise in drug-resistant tuberculosis incidence in Paraná, with specific regional hotspots.
• Forecasting suggests a continued increase through 2030 if current trends persist.
• Enhanced surveillance, treatment adherence monitoring, and transmission interruption are vital for achieving tuberculosis elimination goals.