Perfil epidemiológico dos casos de tuberculose no estado do Maranhão durante os anos 2012 a 2022

Abstract

Tuberculosis (TB) is an infectious disease that poses a major public health challenge, especially in developing countries. In Brazil, the North and Northeast regions have a high incidence of the disease, with the state of Maranhão being one of the most affected. TB is aggravated by unfavorable socioeconomic conditions and risk factors such as co-infection with HIV, smoking, and diabetes. Therefore, the present study aimed to analyze the epidemiological profile of TB cases in the state of Maranhão between 2012 and 2022. For this, the DATASUS databases were used through the access “Tuberculosis Cases – Since 2001 (SINAN)”. Demographic variables (age group, sex, education, race, area of residence), clinical variables (clinical form of TB, type of entry), and lifestyle (smoking, alcoholism) were analyzed. Between 2012 and 2022, 28,150 cases of TB were confirmed in Maranhão. There was a reduction in 2014 (7.7%) and a peak in 2022 (11.5%). The results showed that the most affected age group was 20 to 39 years old (42.85%), and the most affected were males (66%). Regarding education, they had incomplete elementary education (19.7%). The brown race was the most common, corresponding to 72.33% of cases. The majority lived in urban areas (71.44%). The most frequent form was pulmonary (89.91%). Regarding the type of admission, most patients were new cases (82.24%). The first bacilloscopy, a laboratory test used to diagnose tuberculosis, was positive in 50.26%, and the second in 44.23%. In the sputum smear microscopy performed in the 2nd month, (4.67%) were positive, and in the sputum smear microscopy in the 6th month, 0.81% were positive. Among the closed cases, 69.90% were cured, of those who died due to tuberculosis, 4.35%. Regarding Directly Observed Treatment (DOT), 27.25% underwent treatment under observation. Risk factors included smoking (18.68%), alcohol use (16.0%) and illicit drugs (12.4%). Among the comorbidities, 10.51% were HIV-positive, 1.85% had mental illness, and 10.08% had diabetes mellitus. The results of this study highlight the need for public health actions that should focus on improving access to health services and promoting educational campaigns to increase adherence to treatment. Furthermore, these findings reinforce the importance of strategies adapted to local realities for effective TB control in Maranhão and other high incidence regions in Brazil