Alves Luana Seles, Berra Thaís Zamboni, Alves Yan Mathias, Ferezin Letícia Perticarrara, Vinci André Luiz Teixeira, Tavares Reginaldo Bazon Vaz, Tártaro Ariela Fehr, Gomes Dulce, Arcêncio Ricardo Alexandre
Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil.
University of Évora, Évora, Portugal.
Sci Rep. 2025 Mar 11;15(1):8353. doi: 10.1038/s41598-025-93476-6.
The rapid spread of COVID-19 have overwhelmed health systems, especially in the care of chronic disease such as tuberculosis and diabetes. The objective of the study was to analyze the magnitude and relevance of tuberculosis-diabetes and diabetes-COVID-19 comorbidities in spatial risk areas and their factors associated with unfavorable outcomes in the Brazilian population between 2020 and 2022. An ecological study was carried out in Brazilian municipalities. The population was composed by cases of tuberculosis-diabetes and diabetes-COVID-19 comorbidities, registered in the Influenza Epidemiological Surveillance Information System (SIVEP-GRIPE) and in DATASUS from 2020 to 2022. The Scan Statistics technique was used to identify spatial risk clusters. Binary logistic regression was then employed to understand the relationship between outcomes and comorbidities, considering clinical and sociodemographic variables. A total of 24,750 cases of tuberculosis-diabetes comorbidity were identified, which consisted of an incidence of 3.2 cases per 100,000 inhabitants. Risk clusters were identified in the Central-West and North regions. 303,210 cases of diabetes- COVID-19 comorbidity were identified, resulting in an incidence of 0.4 cases per 100,000 inhabitants. São Paulo-SP, Rio de Janeiro-RJ and Belo Horizonte-MG were the municipalities with the highest spatial risk of illness. The analysis of the spatial risk areas revealed distinct patterns in the geographic distribution of comorbidities. Based on the findings, it is concluded that comorbidities between tuberculosis and diabetes, as well as between COVID-19 and diabetes, represent significant challenges for public health in Brazil, deserving attention from health authorities and the scientific community.
新冠病毒病（COVID-19）的迅速传播使卫生系统不堪重负，尤其是在结核病和糖尿病等慢性病的护理方面。本研究的目的是分析2020年至2022年巴西人群中结核病-糖尿病和糖尿病-COVID-19合并症在空间风险区域的严重程度和相关性，以及与不良结局相关的因素。在巴西各市开展了一项生态学研究。研究人群包括2020年至2022年在流感流行病学监测信息系统（SIVEP-GRIPE）和巴西统一医疗系统（DATASUS）中登记的结核病-糖尿病和糖尿病-COVID-19合并症病例。采用扫描统计技术识别空间风险聚集区。随后采用二元逻辑回归分析，在考虑临床和社会人口统计学变量基础上，了解结局与合并症之间的关系。共识别出24750例结核病-糖尿病合并症病例，发病率为每10万居民3.2例。在中西部和北部地区发现了风险聚集区。共识别出303210例糖尿病-COVID-19合并症病例，发病率为每10万居民0.4例。圣保罗州、里约热内卢州和米纳斯吉拉斯州贝洛奥里藏特市是疾病空间风险最高的城市。对空间风险区域的分析揭示了合并症地理分布的不同模式。基于这些发现，得出结论：结核病与糖尿病之间以及COVID-19与糖尿病之间的合并症对巴西公共卫生构成重大挑战，值得卫生当局和科学界关注。
