Perfil epidemiológico da tuberculose na zona rural brasileira: um estudo ecológico

Abstract

Introduction: Tuberculosis still constitutes a significant public health problem in Brazil, leading to a high mortality rate and serious impairments to the healthcare system, despite being a disease with free treatment available in the Unified Health System. In rural areas, challenges in addressing the disease are intensified and compounded by deficiencies in the quality of information available on the case landscape. Objective: To characterize the epidemiological profile of tuberculosis in the population residing in rural areas of Brazil from 2001 to 2022. Method: An ecological study with a descriptive analysis of notified cases of tuberculosis in the Brazilian rural zone was conducted using the Information System for Notifiable Diseases, within the temporal scope of 2001 to 2022. RESULTS: There was a predominance of tuberculosis affecting males, individuals of mixed race, economically active age groups, with low levels of education, and residents in the Northeast region of the country. The primary presentation of the disease was pulmonary, with sputum smear microscopy being the most commonly used diagnostic method. Directly observed treatment was infrequently utilized, and the cure rates fell below those estimated by the World Health Organization. The treatment abandonment rate exceeded what is considered acceptable for effective disease control. Additionally, alcoholism stood out as the most common risk behavior in the studied group, although smoking and illicit drug use were also present. The coexistence of TB with diabetes and HIV-TB coinfection was observed in this context. The main challenges faced by the rural population involved cultural, social, and geographical limitations in accessing healthcare services. Furthermore, there was a significant occurrence of unknown data in notifications, which, for some variables such as correlation with aids, alcoholism, smoking, and illicit drug use, exceeded the number of official records. Conclusion: Given the identified profile, it emphasizes the importance of strengthening healthcare services, both in Primary Health Care, to ensure healthcare access, and in managerial and health surveillance levels, aiming to ensure transparency in information dissemination. This multi-level approach is essential for achieving the necessary resolution to reduce social disparities and provide comprehensive care, as well as to elucidate the true profile of the disease for informed decision-making