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. 2023 Sep 20;8(9):454.
doi: 10.3390/tropicalmed8090454.

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

Carlos Dornels Freire de Souza  1 , Epaminondas Ribeiro Dias Neto  1 , Thais Silva Matos  2 , Ana Carolina Furtado Ferreira  1 , Márcio Bezerra-Santos  3 , Adeilton Gonçalves da Silva Junior  4 , Rodrigo Feliciano do Carmo  5   6
Affiliations

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

Carlos Dornels Freire de Souza et al. Trop Med Infect Dis. .

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.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pernambuco, Brazil.
Figure 2
Figure 2
Temporal analysis of the incidence of tuberculosis in the pre-pandemic period, 2001–2019. Pernambuco, Brazil.
Figure 3
Figure 3
Spatial analysis of tuberculosis incidence in the pre-pandemic (2001–2019) and pandemic (2020 and 2021) periods. Pernambuco, Brazil.
Figure 4
Figure 4
Impact of the COVID-19 pandemic on the diagnosis of new cases of tuberculosis in Pernambuco, according to municipalities in the state. Pernambuco, Brazil, 2020 and 2021.
See this image and copyright information in PMC

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