A Clinical-Epidemiological and Geospatial Study of Tuberculosis in a Neglected Area in the Amazonian Region Highlights the Urgent Need for Control Measures

• Published in: International journal of environmental research and public health 2021-02, Vol.18 (3), p.1335
• Main Authors: Mesquita, Cristal Ribeiro, Conceição, Emilyn Costa, Monteiro, Lúcia Helena Martins Tavares, da Silva, Odinea Maria, Lima, Luana Nepomuceno Gondim Costa, de Oliveira, Rafael Aleixo Coelho, de Brito, Artemir Coelho, Guimarães, Ricardo José de Paula Souza E, Lima, Karla Valéria Batista
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Antibiotics, Antitubercular - therapeutic use; Brazil - epidemiology; Coronaviruses; Data analysis; Disease; Drug resistance; Epidemiology; HIV; Human immunodeficiency virus; Humans; Information systems; Microscopy; Multidrug resistance; Mycobacterium tuberculosis; Neoplasm Recurrence, Local; Public health; Rifampin; Sensitivity and Specificity; Statistical analysis; Statistical methods; Trends; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis - prevention & control
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18031335

Tuberculosis (TB) is an infectious communicable disease, which despite global efforts, still needs special attention in regions with difficult access. This study aims to describe the spatial and epidemiological trends of TB incidences from 2013 to 2018 in Marajó Island, the Amazonian region, Pará, Brazil. We have obtained secondary data from the Brazilian TB databases and performed geospatial and statistical analyses on the data for new TB cases, relapses, and re-admissions. From 2013 to 2018, 749 new cases were reported, in which the diagnostics (culture) was not performed for 652 (87.2%) patient samples, the drug resistance test (DST) was performed for nine (1.2%) samples, and one (0.13%) was multidrug-resistant TB (MDR-TB). The rapid molecular testing (RMT) was performed on 40 (5.3%) patient samples, with results indicating that eight (20%) were susceptible to rifampicin and two (5%) were rifampicin resistant. Overall, the cure rate was 449 (66.7%), while relapses and re-admissions were 41 and 44, respectively. On the geospatial distribution, the municipality of Soure stands out with a high number of incidences, relapses, and re-admissions. Spatially, the eight MDR cases were randomly distributed. Our data highlight the urgent need for TB control measures in this region, by introducing the Xpert-Ultra MTB/RIF (Cepheid, Sunnyvale, CA, USA) and Ogawa-Kudoh.