巴西巴拉那州被剥夺自由人群中耐多药结核病的趋势和空间分布

Trend and Spatial Distribution of Drug-Resistant Tuberculosis in Liberty-Deprived Populations in the State of Paraná, Brazil.

作者信息

Santos Márcio Souza Dos, Berra Thaís Zamboni, Scholze Alessandro Rolim, Delpino Felipe Mendes, Ramos Antônio Carlos Vieira, Alves Yan Mathias, Costa Fernanda Bruzadelli Paulino da, Almeida Crispim Juliane de, Giacomet Clóvis Luciano, Moura Heriederson Sávio Dias, Teibo Titilade Kehinde Ayandeyi, Peres Ana Carolina Silva, Freitas Giselle Lima de, Pieri Flávia Meneguetti, Arcêncio Ricardo Alexandre

机构信息

Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 05403-000, SP, Brazil.

Department of Nursing, Federal University of Minas Gerais, Belo Horizonte 30130-100, MG, Brazil.

出版信息

Trop Med Infect Dis. 2022 Sep 25;7(10):266. doi: 10.3390/tropicalmed7100266.

DOI:10.3390/tropicalmed7100266

PMID:36288007

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9610271/

Abstract

(1) Background: Tuberculosis remains a public health problem in the world. This study evaluated the temporal trends, distribution, and spatial associations of drug-resistant tuberculosis in liberty-deprived populations in the state of Paraná, Brazil. (2) Methods: An ecological study was developed using all cases of drug-resistant tuberculosis in penal establishments reported by the Brazilian Notifiable Diseases Information System between 2008 and 2018. For the time trend, the Prais-Winsten method was used. To verify the spatial association, the Getis-Ord Gi* technique was used. (3) Results: During the study period, 653 cases of tuberculosis were reported in the studied population, of which 98 (15%) were drug-resistant. Prais-Winsten autoregression identified an increasing trend, with APC = 15.08% (95% CI: 0.02-0.09) from 2008 to 2018; when analyzed from 2012 to 2018, the trend increased even more, with APC = 23.31% (95% CI: 0.01-0.16). Hotspots were also noted in the north, east, and west macro-regions of the state. (4) Conclusions: The presence of drug-resistant tuberculosis, as well as an increasing trend of these cases, was evidenced in all regions of the state among liberty-deprived populations,. The spatial analysis revealed priority areas for drug-resistant tuberculosis in penal establishments.

摘要

(1) 背景：结核病仍是全球公共卫生问题。本研究评估了巴西巴拉那州被剥夺自由人群中耐多药结核病的时间趋势、分布及空间关联。(2) 方法：开展一项生态学研究，利用巴西法定传染病信息系统报告的2008年至2018年监狱机构中所有耐多药结核病病例。对于时间趋势，采用普雷斯 - 温斯坦方法。为验证空间关联，采用Getis - Ord Gi* 技术。(3) 结果：在研究期间，研究人群中报告了653例结核病病例，其中98例（15%）为耐多药病例。普雷斯 - 温斯坦自回归分析确定呈上升趋势，2008年至2018年期间年度百分比变化率（APC）为15.08%（95%置信区间：0.02 - 0.09）；从2012年至2018年分析时，趋势上升更为明显，APC为23.31%（95%置信区间：0.01 - 0.16）。该州北部、东部和西部宏观区域也发现了热点地区。(4) 结论：在该州所有地区的被剥夺自由人群中均证实存在耐多药结核病，且这些病例呈上升趋势。空间分析揭示了监狱机构中耐多药结核病的优先防控区域。