Análise clínica-epidemiológica da tuberculose diante do cenário pandêmico da Covid-19

Abstract

Introduction: Since 1993 Tuberculosis is considered an emergency with a global impact on public health, being considered between the years 2015 and 2020 the infectious disease that killed the most in the world. However, the 2020s brought a hitherto unknown challenge to the fight against Tuberculosis, the Covid-19 pandemic, which directly impacted the care and health strategies related to Tuberculosis, making it necessary to restructure the understanding of the factors that surround it. Tuberculosis, as well as its public health policies. Objective: To evaluate the temporal variation and trend of Tuberculosis pointing to the Covid-19 pandemic as a challenge for health services in the period from 2010 to 2022, in the capital of João Pessoa - Paraíba, Brazil. Materials and methods: This is an analytical study, with a cross-sectional approach and a quantitative approach. The study population consisted of all notified cases of Tuberculosis in the Notifiable Diseases Information System (Sinan) between the years 2010 to 2022 in the city of João Pessoa, Paraíba. The defined sample followed the census sampling criteria. Data collection was carried out in an exploratory manner in the period between November and December 2022 and January 2023. The study data were entered into Excel spreadsheets, subsequently, the information contained in this database was transferred to the SPSS statistical program, version 25.0, where the absolute and relative frequencies and rate of occurrence of tuberculosis were evaluated, using Pearson's Chi-square test or Fisher's Exact Test, Mann-Whitney Test and Likelihood Ratio Test. The study was submitted to the Research Ethics Committee, obtaining an approval opinion under CAAE nº 56637722.0.1001.5078 and complying with the guidelines of resolution 466/12 of the National Health Council. Results: It was possible to observe a trend of underreporting of Tuberculosis in the period studied and in comparison with the pre-pandemic period, in addition to the accentuation of social inequalities involved in the profile of the disease during the pandemic, as well as unprecedented results of increased entries due to re-entry after abandonment and the use of the rapid molecular test, and the decrease in the use of other laboratory diagnostic means for detecting the disease, as well as the increase in unfavorable outcomes of TB cases during the pandemic, which reflects the fragility of the health system and entails in the precariousness of assistance to users and in public health policies that define the needs for action in the fight against Tuberculosis.