耐多药结核病风险的空间聚集与照护制图
Spatial clusters of risk and cartography of care for drug-resistant tuberculosis.
作者信息
Ballestero Jaqueline Garcia de Almeida, Silva Júnior José Nildo de Barros, Arroyo Luiz Henrique, Pelissari Daniele Maria, Rigolin Isabela Zaccaro, Palha Pedro Fredemir, Monroe Aline Aparecida, Ferreira Quézia Rosa, Leal Gilberto da Cruz, Teixeira Leonora de Oliveira, Costa Yury Bitencourt da, Pinto Ione Carvalho, Andrade Rubia Laine de Paula, Arcêncio Ricardo Alexandre
机构信息
Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, SP, Brasil.
Universidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil.
出版信息
Rev Saude Publica. 2025 Jun 30;59:e11. doi: 10.11606/s1518-8787.2025059006489. eCollection 2025.
OBJECTIVE
To identify spatial clusters of risk and map the care network for people with drug-resistant tuberculosis in the state of São Paulo.
METHODS
This is an ecological study, carried out by collecting data from the Special Tuberculosis Treatment Information System (Site-TB) of people treated for drug-resistant tuberculosis from 2013 to 2020, in the state of São Paulo. Mapping was carried out using Kernel and scan statistic techniques.
RESULTS
1,084 cases were reported in the period analyzed. São Paulo, Ribeirão Preto, Santos, Guarulhos, and Campinas were the municipalities with the highest number of cases. The spatial pattern of agglomeration of cases and referral centers for treatment were similar, with gaps in coverage in the southwest and northwest of the state. Six spatial clusters were identified: four low-risk and two high-risk, located in São Paulo, Diadema, Santos, and Guarujá.
CONCLUSIONS
The concentration of cases and tertiary referral centers in metropolitan areas highlights inequalities in access to treatment for drug-resistant tuberculosis. These findings indicate the need for health policies to expand diagnosis and treatment, improving the control of drug-resistant tuberculosis in the state of São Paulo.
目的
确定耐药结核病风险的空间聚集情况，并绘制圣保罗州耐药结核病患者的护理网络地图。
方法
这是一项生态学研究，通过收集2013年至2020年圣保罗州耐药结核病治疗患者的特殊结核病治疗信息系统（Site-TB）的数据来开展。使用核密度估计和扫描统计技术进行绘图。
结果
在分析期间报告了1084例病例。圣保罗、里贝朗普雷图、桑托斯、瓜鲁柳斯和坎皮纳斯是病例数最多的城市。病例聚集的空间模式与治疗转诊中心相似，该州西南部和西北部存在覆盖空白。确定了六个空间聚集区：四个低风险区和两个高风险区，分别位于圣保罗、迪亚德马、桑托斯和瓜鲁雅。
结论
大都市地区病例和三级转诊中心的集中凸显了耐药结核病治疗可及性方面的不平等。这些发现表明需要制定卫生政策来扩大诊断和治疗，改善圣保罗州耐药结核病的控制。
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