Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil.
Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
Cad Saude Publica. 2020 Jun 26;36(6):e00081319. doi: 10.1590/0102-311X00081319. eCollection 2020.
The objective was to analyze the temporal trend of tuberculosis incidence rates in Brazilian states and regions to identify patterns and inequalities. We carried out an ecological study of incidence rates per 100,000 inhabitants aged between 20 and 59 years with tuberculosis in Brazil and in their respective states from 2001 to 2017 according to annual percentage change and joinpoint regression. A significant decrease of -15.1% in the annual variation (95%CI: -27.2; -1.0) was observed in Roraima between the years 2003-2007. In the Central Region, Goiás registered an annual average variation of -2.5% per year (95%CI: -3.6; -1.3). Five out of nine Northeastern states had decreasing annual variations throughout the studied series. Espírito Santo and Rio de Janeiro were the states of the Southeast that presented decreasing between 2001-2017. In the Southern Region, the state of Paraná was the only one with the same annual variation of -3.7% (95%CI: -4.1; -3.2). In Brazil, the average annual percentage change was -1.8% (95%CI: -2.4; -1.1). The results of this study showed a decline in the incidence of tuberculosis in Brazil. However, regional and intra-regional differences were observed. Determining the trend pattern of tuberculosis incidence may assist in the planning and implementation of national tuberculosis control policies.
本研究旨在分析巴西各州和地区结核病发病率的时间趋势,以确定发病模式和差异。我们开展了一项关于巴西及其各州 2001 年至 2017 年期间年龄在 20 至 59 岁之间的每 10 万居民结核病发病率的生态学研究,根据年度百分比变化和连接点回归进行分析。在 2003 年至 2007 年期间,罗赖马州的发病率年度变化呈显著下降趋势,下降幅度为 -15.1%(95%CI:-27.2;-1.0)。在中地区,戈亚斯州的发病率每年平均变化为-2.5%(95%CI:-3.6;-1.3)。在 9 个东北部州中,有 5 个州的发病率年度变化呈下降趋势。在东南部地区,2001 年至 2017 年间,累西腓和里约热内卢州的发病率呈下降趋势。在南部地区,只有巴拉那州的发病率年度变化相同,为-3.7%(95%CI:-4.1;-3.2)。巴西的平均年度百分比变化为-1.8%(95%CI:-2.4;-1.1)。本研究结果表明,巴西的结核病发病率呈下降趋势,但仍存在地区和区域内差异。确定结核病发病率的趋势模式可能有助于制定和实施国家结核病控制政策。