Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012

Abstract

Objective: To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. Methods: This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Results: Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0-to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV coinfection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Conclusions: Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished.

Predictors of Mortality among Individuals with Tuberculosis and Human Immunodeficiency Virus Coinfection at a Reference Center in Southeastern Brazil: A Retrospective Cohort Study

“…[31][32][33] Furthermore, between 2002 and 2012, the incidence of TB/HIV coinfection in Brazil increased by 3.8%, indicating a growing importance of HIV in TB epidemiology. 34 In our cohort, 49.4% presented detectable viral load (>40 copies/mm 3 ). Recent studies have reported that viral suppression rates range from 65% to 80% according to different antiretroviral regimens.…”

Aspectos clínicos e epidemiológicos da tuberculose em pacientes com HIV/aids

“…Neste estudo, a incidência de pessoas diagnosticadas com coinfecção TB-HIV no estado de Alagoas apresentou tendência de crescimento ao longo dos anos de 2001 a 2016, indicando a ocorrência de aumento no número de pessoas com TB associada ao HIV. Corroborou-se, neste trabalho, com os achados de Gaspar et al 11 que identificaram que as taxas de incidência da tuberculose em pacientes com HIV vêm apresentando valores de detecção/diagnóstico crescentes no território nacional. No entanto, mesmo com o aumento no número de casos, durante todo o período de investigação a incidência de TB-HIV para o estado de Alagoas manteve-se inferior às taxas encontradas para o Brasil, exceto para o último ano desta pesquisa 7,11 .…”

“…Houve também predomínio da coinfecção em pacientes adultos, de baixa ou nenhuma escolaridade e de cor da pele negra. Tal perfil é conclusão semelhante à de diversos outros estudos realizados no Brasil para a coinfecção TB-HIV [11][12][13][14][18][19][20] , além de compatível com o perfil dos pacientes soropositivos para o HIV/aids no país 8,21 . O perfil é concordante também com as características da coinfecção TB-HIV nas Américas 1,22 .…”

“…Em concordância com a literatura especializada, verificou-se que o HIV constitui em grande desafio para o controle da TB 11 . Portanto, essa situação implica na necessidade de unir esforços e desenvolver ações conjuntas para o enfrentamento de ambas patologias.…”

Tuberculosis registration rates analysis and prediction based on exponential smoothing model: could tuberculosis control milestones be achieved in 2020, 2025 in Henan province, China?

“…Using mathematical models to explore the pattern of incidence had been developed in infectious diseases control. For example, time series analysis was used for hand, foot, and mouth disease and TB [9,10], autoregressive integrated moving average (ARIMA) model for hepatitis A and in uenza [11,12], temporal analysis for TB and human immunode ciency virus (TB/HIV) co-infection [13]. Different models are suitable for different data characteristics.…”