Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/179917 |
Resumo: | OBJECTIVE: To describe the spatial and temporal distribution of TB-HIV co-infection, as well as the profile of the characteristics of the co-infected population in the municipality of São Paulo. METHODS: This is an ecological and time series study with data from the Tuberculosis Patient Control System (TBWeb), including all new cases of tuberculosis co-infected individuals with HIV living in the municipality from 2007 to 2015. Time trends of the disease were analyzed using Prais-Winsten regression. The cases were geocoded by the address of residence for the elaboration of maps with the incidence rates smoothed by the local empirical Bayesian method. The global and local Moran indexes evaluated spatial autocorrelation. Individuals’ profiles were described and the characteristics of the cases with and without fixed residence were compared by Pearson’s chi-square or Fisher’s exact tests. RESULTS: We analyzed 6,092 new cases of TB-HIV co-infection (5,609 with fixed residence and 483 without fixed residence). The proportion of TB-HIV co-infection ranged from 10.5% to 13.7%, with a drop of 3.0% per year (95%CI -3.4 – -2.6) and was higher in individuals without fixed residence. Incidence rates decreased by 3.6% per year (95%CI -4.4% – -2.7%), declining from 7.0 to 5.3 per 100,000 inhabitants/year. Co-infection showed positive and significant spatial autocorrelation, with heterogeneous spatial pattern and a high-risk cluster in the central region of the municipality. Cure was achieved in 55.5% of cases with fixed residence and in 32.7% of those without a fixed residence. CONCLUSIONS: The data indicate an important advance in the control of TB-HIV co-infection in the period analyzed. However, we identified areas and populations that were unequally affected by the disease and that should be prioritized in the improvement of actions to prevent and control co-infection. |
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Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileiraTB-HIV co-infection: spatial and temporal distribution in the largest Brazilian metropolisTuberculosisHIV infections, epidemiologySpatial analysisTime series studiesTuberculose, epidemiologiaInfecções por HIV, epidemiologiaAnálise EspacialEstudos de Séries TemporaisOBJECTIVE: To describe the spatial and temporal distribution of TB-HIV co-infection, as well as the profile of the characteristics of the co-infected population in the municipality of São Paulo. METHODS: This is an ecological and time series study with data from the Tuberculosis Patient Control System (TBWeb), including all new cases of tuberculosis co-infected individuals with HIV living in the municipality from 2007 to 2015. Time trends of the disease were analyzed using Prais-Winsten regression. The cases were geocoded by the address of residence for the elaboration of maps with the incidence rates smoothed by the local empirical Bayesian method. The global and local Moran indexes evaluated spatial autocorrelation. Individuals’ profiles were described and the characteristics of the cases with and without fixed residence were compared by Pearson’s chi-square or Fisher’s exact tests. RESULTS: We analyzed 6,092 new cases of TB-HIV co-infection (5,609 with fixed residence and 483 without fixed residence). The proportion of TB-HIV co-infection ranged from 10.5% to 13.7%, with a drop of 3.0% per year (95%CI -3.4 – -2.6) and was higher in individuals without fixed residence. Incidence rates decreased by 3.6% per year (95%CI -4.4% – -2.7%), declining from 7.0 to 5.3 per 100,000 inhabitants/year. Co-infection showed positive and significant spatial autocorrelation, with heterogeneous spatial pattern and a high-risk cluster in the central region of the municipality. Cure was achieved in 55.5% of cases with fixed residence and in 32.7% of those without a fixed residence. CONCLUSIONS: The data indicate an important advance in the control of TB-HIV co-infection in the period analyzed. However, we identified areas and populations that were unequally affected by the disease and that should be prioritized in the improvement of actions to prevent and control co-infection.OBJETIVO: Descrever a distribuição espacial e temporal da coinfecção TB-HIV, assim como o perfil das características da população coinfectada no município de São Paulo. MÉTODOS: E studo e cológico e d e s érie t emporal c om d ados d o S istema d e C ontrole d e Pacientes com Tuberculose (TBWeb), incluindo todos os casos novos de tuberculose coinfectados pelo HIV residentes no município no período de 2007 a 2015. Tendências temporais do agravo foram analisadas por regressão de Prais-Winsten. Os casos foram geocodificados pelo endereço de residência para a elaboração de mapas com as taxas de incidência suavizadas pelo método bayesiano empírico local. Os índices de Moran global e local avaliaram a autocorrelação espacial. O perfil dos indivíduos foi descrito e as características dos casos com e sem residência fixa foram comparadas pelos testes de qui-quadrado ou exato de Fisher. RESULTADOS: Foram analisados 6.092 casos novos de coinfecção TB-HIV (5.609 com residência fixa e 483 sem residência fixa). A proporção de coinfecção TB-HIV variou de 10,5% a 13,7%, com queda de 3,0% ao ano (IC95% -3,4 – -2,6), e foi maior nos indivíduos sem residência fixa em todo o período. As taxas de incidência apresentaram diminuição de 3,6% ao ano (IC95% -4,4% – -2,7%), declinando de 7,0 para 5,3 por 100 mil habitantes/ano. A coinfecção apresentou autocorrelação espacial positiva e significativa, com padrão espacial heterogêneo e um aglomerado de alto risco na região central do município. A cura foi alcançada em 55,5% dos casos com residência fixa e em 32,7% daqueles sem residência. CONCLUSÕES: Os dados indicam um importante avanço no controle da coinfecção TB-HIV no período analisado. Todavia, foram identificadas áreas e populações que se apresentaram desigualmente afetadas pelo agravo, e que devem ser priorizadas no aprimoramento das ações de prevenção e controle da coinfecção.Universidade de São Paulo. Faculdade de Saúde Pública2020-12-14info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/17991710.11606/s1518-8787.2020054002108Revista de Saúde Pública; Vol. 54 (2020); 112Revista de Saúde Pública; Vol. 54 (2020); 112Revista de Saúde Pública; v. 54 (2020); 1121518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/179917/166473https://www.revistas.usp.br/rsp/article/view/179917/166474https://www.revistas.usp.br/rsp/article/view/179917/166475Copyright (c) 2020 Revista de Saúde Públicahttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCavalin, Roberta FigueiredoPellini, Alessandra Cristina GuedesLemos, Regina Rocha Gomes deSato, Ana Paula Sayuri2020-12-14T21:29:51Zoai:revistas.usp.br:article/179917Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2020-12-14T21:29:51Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira TB-HIV co-infection: spatial and temporal distribution in the largest Brazilian metropolis |
title |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira |
spellingShingle |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira Cavalin, Roberta Figueiredo Tuberculosis HIV infections, epidemiology Spatial analysis Time series studies Tuberculose, epidemiologia Infecções por HIV, epidemiologia Análise Espacial Estudos de Séries Temporais |
title_short |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira |
title_full |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira |
title_fullStr |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira |
title_full_unstemmed |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira |
title_sort |
Coinfecção TB-HIV: distribuição espacial e temporal na maior metrópole brasileira |
author |
Cavalin, Roberta Figueiredo |
author_facet |
Cavalin, Roberta Figueiredo Pellini, Alessandra Cristina Guedes Lemos, Regina Rocha Gomes de Sato, Ana Paula Sayuri |
author_role |
author |
author2 |
Pellini, Alessandra Cristina Guedes Lemos, Regina Rocha Gomes de Sato, Ana Paula Sayuri |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Cavalin, Roberta Figueiredo Pellini, Alessandra Cristina Guedes Lemos, Regina Rocha Gomes de Sato, Ana Paula Sayuri |
dc.subject.por.fl_str_mv |
Tuberculosis HIV infections, epidemiology Spatial analysis Time series studies Tuberculose, epidemiologia Infecções por HIV, epidemiologia Análise Espacial Estudos de Séries Temporais |
topic |
Tuberculosis HIV infections, epidemiology Spatial analysis Time series studies Tuberculose, epidemiologia Infecções por HIV, epidemiologia Análise Espacial Estudos de Séries Temporais |
description |
OBJECTIVE: To describe the spatial and temporal distribution of TB-HIV co-infection, as well as the profile of the characteristics of the co-infected population in the municipality of São Paulo. METHODS: This is an ecological and time series study with data from the Tuberculosis Patient Control System (TBWeb), including all new cases of tuberculosis co-infected individuals with HIV living in the municipality from 2007 to 2015. Time trends of the disease were analyzed using Prais-Winsten regression. The cases were geocoded by the address of residence for the elaboration of maps with the incidence rates smoothed by the local empirical Bayesian method. The global and local Moran indexes evaluated spatial autocorrelation. Individuals’ profiles were described and the characteristics of the cases with and without fixed residence were compared by Pearson’s chi-square or Fisher’s exact tests. RESULTS: We analyzed 6,092 new cases of TB-HIV co-infection (5,609 with fixed residence and 483 without fixed residence). The proportion of TB-HIV co-infection ranged from 10.5% to 13.7%, with a drop of 3.0% per year (95%CI -3.4 – -2.6) and was higher in individuals without fixed residence. Incidence rates decreased by 3.6% per year (95%CI -4.4% – -2.7%), declining from 7.0 to 5.3 per 100,000 inhabitants/year. Co-infection showed positive and significant spatial autocorrelation, with heterogeneous spatial pattern and a high-risk cluster in the central region of the municipality. Cure was achieved in 55.5% of cases with fixed residence and in 32.7% of those without a fixed residence. CONCLUSIONS: The data indicate an important advance in the control of TB-HIV co-infection in the period analyzed. However, we identified areas and populations that were unequally affected by the disease and that should be prioritized in the improvement of actions to prevent and control co-infection. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-12-14 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/179917 10.11606/s1518-8787.2020054002108 |
url |
https://www.revistas.usp.br/rsp/article/view/179917 |
identifier_str_mv |
10.11606/s1518-8787.2020054002108 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/179917/166473 https://www.revistas.usp.br/rsp/article/view/179917/166474 https://www.revistas.usp.br/rsp/article/view/179917/166475 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Revista de Saúde Pública http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Revista de Saúde Pública http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf text/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 54 (2020); 112 Revista de Saúde Pública; Vol. 54 (2020); 112 Revista de Saúde Pública; v. 54 (2020); 112 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221801795551232 |