An ecological study mapping socioeconomic inequalities in tuberculosis incidence in a southern state of Brazil

•Tuberculosis showed a complexity of socioeconomic factors linked to its incidence.•There was a strong spatial autocorrelation among municipal incidence coefficients.•The incidence increased with the rise in the municipal development index.•Greater income distribution inequality was associated with...

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Published in:Spatial and spatio-temporal epidemiology 2024-11, Vol.51, p.100689, Article 100689
Main Authors: Lima, Lucas Vinícius de, Pavinati, Gabriel, Palmieri, Isadora Gabriella Silva, Bernardo, Pedro Henrique Paiva, Santos, Vitória Maytana Alves dos, Gomes, Melissa Ferrari, Silveira, Juliana Taques Pessoa da, Magalhães, Francisco Beraldi de, Gil, Nelly Lopes de Moraes, Magnabosco, Gabriela Tavares
Format: Article
Language:English
Subjects:
Disease mapping
Ecological studies
Negative binomial regression
Socioeconomic vulnerability
Spatial analysis
Tuberculosis
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Summary:•Tuberculosis showed a complexity of socioeconomic factors linked to its incidence.•There was a strong spatial autocorrelation among municipal incidence coefficients.•The incidence increased with the rise in the municipal development index.•Greater income distribution inequality was associated with elevated incidence.•Inadequate environmental sanitation elevated the occurrence of tuberculosis. To analyze the spatial patterns and factors associated with tuberculosis incidence in the municipalities of Paraná, Brazil. Ecological study examining new tuberculosis cases from 2018 to 2022 in Paraná’s 399 municipalities. Incidence coefficients, relative risk, and local indicator of spatial autocorrelation were estimated. Negative binomial models were applied to identify associated factors. High-risk areas were observed in the coastal/port, north, and northeast regions. The following factors positively influenced tuberculosis incidence: municipal development index (incidence rate ratio [IRR]: 1.07; 95 % confidence interval [95 % CI]: 1.01–1.14), hospitalizations due to inadequate environmental sanitation (IRR: 1.07; 95 % CI: 1.01–1.14), and Gini index (IRR: 1.09; 95 % CI: 1.02–1.16). Paradoxically, in municipalities with elevated development indices yet marked by socioeconomic disparities—including deficiencies in sanitation—substantial tuberculosis clusters persist. This suggests that income inequality might play a role in perpetuating the incidence even in regions that are otherwise considered developed.
ISSN:1877-5845
DOI:10.1016/j.sste.2024.100689