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Published on: September 5, 2017
Spatio-temporal modeling of tuberculosis among Brazil's elderly: a 20-year ecological and population-based study
Davi Rios do Nascimento1, Sarah Fonseca Serpa2, Adeilton Gonçalves da Silva Júnior3
1Health Situational Analysis Observatory, Federal University of the São Francisco Valley (UNIVASF), Petrolina City, Pernambuco, Brazil. davi.rios@discente.univasf.edu.br.
Background:
Tuberculosis (TB) remains a significant public health issue, with an increasing impact among the elderly population. In Brazil, population aging poses additional challenges to disease control.
Objective:
To analyze the socioepidemiological and clinical profile, as well as the temporal and spatial dynamics of tuberculosis among individuals aged 60 years or older in Brazil between 2001 and 2022.
Methods:
This ecological, population-based study used secondary data on TB cases among older adults reported to the Notifiable Diseases Information System (SINAN). Sociodemographic and clinical characteristics were described, and temporal trends were assessed using Joinpoint regression. Spatial dependence and clusters were analyzed using Global and Local Moran's I statistics.
Results:
A total of 228,912 TB cases were reported among older adults during the study period. Most cases occurred in males (65.8%), individuals aged 60-69 years (57.9%), Black and Brown individuals (46.3%), and those with low or no formal education (53.6%). There was an average annual reduction of 2.37% in TB incidence among the elderly in the country. Of the 27 federative units, 21 showed a decreasing trend, particularly the Federal District (- 4.97%) and Goiás (- 4.03%). Six states showed a stationary trend (Acre, Roraima, Paraíba, Sergipe, Minas Gerais, and Espírito Santo), and none showed a significant increasing trend. Spatial analysis revealed a persistent concentration of high-priority municipalities, especially in the North and Northeast regions, which accounted for 25.4% of the cases.
Conclusions:
Tuberculosis among older adults in Brazil demonstrated an overall declining trend over the past two decades, although with marked regional inequalities and persistent spatial concentration in historically vulnerable territories. These findings underscore the need for targeted strategies for surveillance, diagnosis, and care in priority territories, considering the specificities of population aging.
Clinical Trial Number:
Not applicable.
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