Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study
To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators. An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously repor...
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| Published in | Revista de saúde pública Vol. 58; p. 10 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English Portuguese |
| Published |
Brazil
Faculdade de Saúde Pública da Universidade de São Paulo
01.01.2024
Universidade de São Paulo |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1518-8787 0034-8910 1518-8787 |
| DOI | 10.11606/s1518-8787.2024058005531 |
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| Abstract | To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators.
An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran's indices were used.
A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index.
The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030. |
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| AbstractList | To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators.OBJECTIVETo analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators.An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran's indices were used.METHODSAn ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran's indices were used.A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index.RESULTSA total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index.The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030.CONCLUSIONSThe spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030. To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators. An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran's indices were used. A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index. The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030. ABSTRACT OBJECTIVE To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators. METHODS An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran’s indices were used. RESULTS A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index. CONCLUSIONS The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030. |
| Author | Pavinati, Gabriel Lima, Lucas Vinícius de Bossonario, Pedro Augusto Monroe, Aline Aparecida Magnabosco, Gabriela Tavares Alves, Kleydson Bonfim Andrade Pelissari, Daniele Maria |
| AuthorAffiliation | I Universidade Estadual de Maringá Programa de Pós-Graduação em Enfermagem Maringá PR Brazil Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil II Universidade de São Paulo Programa de Pós-Graduação Enfermagem em Saúde Pública Ribeirão Preto SP Brazil Universidade de São Paulo. Programa de Pós-Graduação Enfermagem em Saúde Pública. Ribeirão Preto, SP, Brazil IV Pan American Health Organization Department of Communicable Diseases and Environmental Determinants of Health Brasília DF Brazil Pan American Health Organization. Department of Communicable Diseases and Environmental Determinants of Health. Brasília, DF, Brazil III Brazilian Ministry of Health Departamento de HIV/aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis Brasília DF Brazil Brazilian Ministry of Health. Departamento de HIV/aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis. Brasília, DF, Brazil |
| AuthorAffiliation_xml | – name: I Universidade Estadual de Maringá Programa de Pós-Graduação em Enfermagem Maringá PR Brazil Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil – name: II Universidade de São Paulo Programa de Pós-Graduação Enfermagem em Saúde Pública Ribeirão Preto SP Brazil Universidade de São Paulo. Programa de Pós-Graduação Enfermagem em Saúde Pública. Ribeirão Preto, SP, Brazil – name: III Brazilian Ministry of Health Departamento de HIV/aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis Brasília DF Brazil Brazilian Ministry of Health. Departamento de HIV/aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis. Brasília, DF, Brazil – name: IV Pan American Health Organization Department of Communicable Diseases and Environmental Determinants of Health Brasília DF Brazil Pan American Health Organization. Department of Communicable Diseases and Environmental Determinants of Health. Brasília, DF, Brazil – name: Universidade Estadual de Maringá – name: Universidade de São Paulo – name: Brazilian Ministry of Health – name: Pan American Health Organization |
| Author_xml | – sequence: 1 givenname: Lucas Vinícius de orcidid: 0000-0002-9582-9641 surname: Lima fullname: Lima, Lucas Vinícius de organization: Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil – sequence: 2 givenname: Gabriel orcidid: 0000-0002-0289-8219 surname: Pavinati fullname: Pavinati, Gabriel organization: Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil – sequence: 3 givenname: Pedro Augusto orcidid: 0000-0001-6287-174X surname: Bossonario fullname: Bossonario, Pedro Augusto organization: Universidade de São Paulo. Programa de Pós-Graduação Enfermagem em Saúde Pública. Ribeirão Preto, SP, Brazil – sequence: 4 givenname: Aline Aparecida orcidid: 0000-0003-4073-2735 surname: Monroe fullname: Monroe, Aline Aparecida organization: Universidade de São Paulo. Programa de Pós-Graduação Enfermagem em Saúde Pública. Ribeirão Preto, SP, Brazil – sequence: 5 givenname: Daniele Maria orcidid: 0000-0002-0760-1875 surname: Pelissari fullname: Pelissari, Daniele Maria organization: Brazilian Ministry of Health. Departamento de HIV/aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis. Brasília, DF, Brazil – sequence: 6 givenname: Kleydson Bonfim Andrade orcidid: 0000-0002-0905-3358 surname: Alves fullname: Alves, Kleydson Bonfim Andrade organization: Pan American Health Organization. Department of Communicable Diseases and Environmental Determinants of Health. Brasília, DF, Brazil – sequence: 7 givenname: Gabriela Tavares orcidid: 0000-0003-3318-6748 surname: Magnabosco fullname: Magnabosco, Gabriela Tavares organization: Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil |
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| Keywords | Tuberculosis Coinfection HIV Análise Espacial Spatial analysis Tuberculose Coinfecção |
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| Title | Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study |
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