[Tuberculosis transmission in the triple border region: Brazil, Paraguay, and Argentina]

Abstract

Tuberculosis is a public health problem in South America, but numerous control strategies have proven ineffective in settings with intense transmission. This study aimed to determine whether the triple border region between Brazil, Argentina, and Paraguay is an area of high tuberculosis transmission. An ecological study was conducted with incidence data and population estimates for the three countries. Mean incidence rates were calculated for 2001 to 2007. Spatial analysis techniques identified high-incidence areas in the region using maps with Bayesian smoothing of rates and spatial averages. During the target period, Foz do Iguaçu, Brazil, had the highest incidence, followed by Ciudad del Este in Paraguay, and Puerto Iguazú in Argentina. The analysis showed a spatial cluster of municipalities with high tuberculosis risk in the triple border region. Tuberculosis in the tri-border area shows increasing or stable incidence rates and municipalities with incidence rates above the State average. The area has high tuberculosis incidence and therefore heavy transmission of the disease.