Bridging the Gaps: Investigating the Complex Impact of the COVID-19 Pandemic on Tuberculosis Records in Brazil

Carlos Dornels Freire de Souza; Epaminondas Ribeiro Dias Neto; Thais Silva Matos; Ana Carolina Furtado Ferreira; Márcio Bezerra-Santos; Adeilton Gonçalves da Silva Junior; Rodrigo Feliciano do Carmo

doi:10.3390/tropicalmed8090454

Bridging the Gaps: Investigating the Complex Impact of the COVID-19 Pandemic on Tuberculosis Records in Brazil

Trop Med Infect Dis. 2023 Sep 20;8(9):454. doi: 10.3390/tropicalmed8090454.

Authors

Carlos Dornels Freire de Souza¹, Epaminondas Ribeiro Dias Neto¹, Thais Silva Matos², Ana Carolina Furtado Ferreira¹, Márcio Bezerra-Santos³, Adeilton Gonçalves da Silva Junior⁴, Rodrigo Feliciano do Carmo^{5

6}

Affiliations

¹ Department of Medicine, Federal University of Vale do São Francisco (UNIVASF), Petrolina 56304-205, Brazil.
² Department of physiotherapy, University of Pernambuco (UPE), Petrolina 56328-900, Brazil.
³ Department of Medicine, Federal University of Alagoas (UFAL), Arapiraca 57309-005, Brazil.
⁴ City Hall of Juazeiro, Bahia 48903-400, Brazil.
⁵ Postgraduate Program in Health and Biological Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina 56304-205, Brazil.
⁶ Postgraduate Program in Biosciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina 56304-205, Brazil.

Abstract

Background: This study aimed to analyze the temporal evolution, spatial distribution, and impact of the COVID-19 pandemic on tuberculosis records in a northeastern state of Brazil.

Methods: This is an ecological study involving all diagnoses of Tuberculosis (TB) in residents of the state of Pernambuco/Brazil. Data were extracted from the National System of Notifiable Diseases. A pre-pandemic COVID-19 temporal analysis (2001-2019), a spatial analysis before (2015-2019) and during the first two pandemic years (2020-2021), and the impact of the COVID-19 pandemic on cases of TB diagnoses in Pernambuco in the years 2020 and 2021 were performed. Inflection point regression models, Global and Local Moran's statistics, and spatial scan statistics were used.

Results: In the period from 2001 to 2019, 91,225 cases of TB were registered in Pernambuco (48.40/100,000 inhabitants), with a tendency of growth starting in 2007 (0.7% per year; p = 0.005). In the pre-pandemic period (2015-2019), 10.8% (n = 20) of Pernambuco municipalities had TB incidence rates below 10/100,000. In 2020, this percentage reached 27.0% (n = 50) and in 2021 it was 17.8% (n = 33). Risk clusters were identified in the eastern region of the state, with five clusters in the pre-pandemic period and in 2021 and six in 2020. In the first year of the pandemic, an 8.5% reduction in the number of new TB cases was observed. In 2021, the state showed a slight increase (1.1%) in the number of new TB cases.

Conclusions: The data indicate that the COVID-19 pandemic may have caused a reduction in the number of new TB case reports in the state of Pernambuco, Brazil.

Keywords: SARS-CoV-2; coronavirus; pandemic; spatial analysis; tuberculosis.

Grants and funding

This research was funded by FACEPE (Fundação de Amparo à Pesquisa do estado de Pernambuco), grant number APQ-0692-4.06/22 (Programa Estadual de Pesquisa Aplicada ao SUS).