Banca de DEFESA: NATALIA DA CUNHA SEVERINO SAMPAIO

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : NATALIA DA CUNHA SEVERINO SAMPAIO
DATE: 24/03/2022
TIME: 14:00
LOCAL: Videoconferência
TITLE:

INCIDENCE OF PULMONARY TUBERCULOSIS AND SOCIOECONOMIC CONDITIONS IN THE STATES OF THE SOUTHEAST REGION OF BRAZIL

KEY WORDS:

Keywords: Pulmonary tuberculosis. Social determinants. Spatial analysis.

PAGES: 99
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Despite the global reduction in infection and mortality rates, tuberculosis (TB) is still among the main public health problems with approximately ¼ of the world population infected by M. tuberculosis and one of the ten main causes of death by a single infectious agent. . In this scenario, despite efforts, goals to reduce morbidity and mortality from TB will not be achieved in Brazil. Given the importance of investigating the factors associated with the incidence of pulmonary TB, the hypothesis of this study concerns the limitation of social indicators, especially the Human Development Index (HDI) and Gini Index (GI), in predicting TB incidence rates. at the municipal aggregation level. Objective: to analyze the spatial correlation between the incidence of pulmonary TB, HDI, GA and other socioeconomic indicators in the southeastern region of Brazil. Methodology: This is a mixed analytical ecological study with time series and spatial aggregation in the municipalities (unit of analysis) of that region in the period 2010-2019 which, in turn, was subdivided into two others: 2010-2014 and 2015-2019, so that there was a comparison between consolidated from the first and the second period. Spatial smoothing methods were used for estimators of TB incidence, Global Moran Index and Univariate and Bivariate Local Spatial Association Indicator (LISA) and spatio-temporal analyzes with SatScan scan statistics for cluster detection and relative risk (RR) for occurrence of pulmonary TB. Spatial regression techniques were also used. Thematic maps were built for analysis of results. Results: With a significance level of 5% for the bivariate LISA, the Moran Index (I) showed a positive autocorrelation between TB incidence and HDI (I = 0.349), per capita income (I = 0.266), complete secondary education (I = 0.323) and intra-household agglomeration (I=0.093). There was a negative autocorrelation for GA (I = 0.144), infant mortality (I = 0.182), Theil-L index (I = 0.156) and the proportion of extremely poor (I = 0.125). In the space-time analysis, 16 probable clusters (p value < 0.05) were identified, mainly in the state of São Paulo. The most likely cluster (cluster nº 1) is located in the coastal region further south of Rio de Janeiro (RR = 2.37) in the period 2015 - 2019. The cluster with the highest relative risk (RR = 13.96) is located in the Midwest region of São Paulo from 2014 to 2018. In spatial regression, the GWR (geographically weighted regression) obtained significant results (p <0.05) for Theil index of work earnings, Gini index, intra-household agglomeration and Municipal HDI with the highest incidence of TB being associated with the worsening of social indicators in some regions. The spatial regression model (R²) explained between 46% and 77% of the variation in TB cases in some regions that were concentrated mainly in the north of Minas Gerais and the border with São Paulo (more to the southwest), state of Espírito Santo, most of the state of Rio de Janeiro and western region, São Paulo in the central region and border with Minas Gerais. Higher incidence of pulmonary TB was autocorrelated with better conditions of human development and income and weaker with intra-household crowding, lower inequality, lower infant mortality and proportion of the extremely poor. Conclusion: A spatial association was found between a higher incidence of pulmonary TB in regions with better human development indicators and greater social inequality, indicating a possible limitation of most of the analyzed indicators in predicting the occurrence of pulmonary TB in the municipalities of the Southeast region, with the exception of household crowding that was associated with a higher incidence of TB.

BANKING MEMBERS:
Externa à Instituição - TAYNÃNA CÉSAR SIMÕES - FIOCRUZ
Externo à Instituição - JOSÉ ROBERTO LAPA E SILVA - UFRJ
Externa ao Programa - 1615288 - ELIETE ALBANO DE AZEVEDO GUIMARAES
Presidente - 174.655.676-53 - PAULO AUGUSTO MOREIRA CAMARGOS - UFMG
Interno - 1084423 - RAFAEL GONCALVES TEIXEIRA NETO