Análise da Distribuição Espacial dos Casos de Tuberculose no Estado da Paraíba e Verificação dos Fatores Associados

Abstract

INTRODUCTION: Tuberculosis (TB) is still a serious public health problem, given its magnitude and social impact, presenting a close relationship with socio-demographic and economic structures. OBJECTIVE: The objective was to evaluate the existence of a structure of spatial autocorrelation between the units and to verify possible association between the occurrence of tuberculosis and socioeconomic and sociodemographic conditions. This is a mixed ecological study with a retrospective character. METHODOLOGY: The methodology used was spatial analysis for area data, composed of 223 municipalities in the state of Paraíba, between the years 2015 and 2018. To assess spatial autocorrelation, the Global and Local Moran Index was used, and to verify the similarity of the measures of the attribute of the areas in the study region in a visual way, a quartile map, a scatter plot of Moran, Lisa Map, and Moran Map were constructed. To correlate the social and economic variables with the cases reported by tuberculosis (TB) of the municipalities in the state of Paraíba, spatial regression models were adjusted, adopting the akaike criterion (AIC) to choose the model that best fit the data. The variables referring to social and economic characteristics came from CENSO 2010. The variables related to notifications for tuberculosis came from the Information System for Notifiable Diseases. RESULTS: 6,082 TB cases were reported in individuals living in the state of Paraíba, from 2015 to 2018. Keeping with an incidence rate per 100 thousand inhabitants, higher than the recommended for the country in all the succeeding years. The Moran Global index showed positive autocorrelation in the cases notified by TB for the years 2015, 2017, 2018. The cities that make up the Mata zone and the Agreste Paraibano, were classified as critical and priority areas. The strong association with the Municipal Human Development Index (MHDI) is emphasized, and while this MHDI improves, the cases of tuberculosis notification increase.