The aim of this study was to analyze the spatial distribution of cases of drug-resistant HIV-tuberculosis coinfection in adults in a state of Brazil and the sociodemographic characteristics of this population.
Methods:
This is a cross-sectional and ecological, and epidemiological study, with focus on spatial analysis. The study population consisted of 49 cases of adults coinfected with drug-resistant HIV-Tuberculosis, reported during the period 2011 to 2018 and residing in the state at the time of notification. The data used were provided by the Secretary of Health of the State of Ceará, and were compound by the database of the Special Treatment Information System for Tuberculosis and the Information System for Notifiable Diseases for the analysis of information epidemiological, social and behavioral data concerning the drug-resistant tuberculosis and AIDS dossiers respectively, in addition to the data provided by the Brazilian Institute of Geography and Statistics on sociodemographic information (IBGE). The epidemiological profile of patients with drug-resistant HIV-TB was traced using descriptive statistics techniques, supported by Microsoft Office Excel 2016. Qui-square test and odds ratio were used for data analysis on the association between sociodemographic and epidemiological characteristics of coinfected patients, with the aid of software R. Spatial analysis was performed through exploratory analysis and spatial autocorrelation by the Moran Global Index, in addition to the Local Spatial Association Index and the spatial regression model. The research was submitted to the Brazil Platform and accepted by the Ethics and Research Committee.
Results:
The 49 cases were diagnosed between 2001 and 2018 and there was an increase in notification in recent years, especially in 2017, which presented the highest percentage of cases (24.49%). The cases were most prevalent in the capital, Fortaleza (63,27), presented positive spatial autocorrelation, with Moran index of 0.036. In relation to the sociodemographic characteristics, 73.4% of the patients were males (79.6%), with 8 years or more of study (63.3%), with no income (53.1%), age group between 30 and 49 years (67.35%). Regarding case outcomes, 32.6% of patients completed treatment, 28.6% were still on treatment, 18.4% died of tuberculosis, and 14.3% abandoned treatment.
Conclusion:
In conclusion, cases of drug-resistant HIV-TB coinfection formed a cluster in the state capital, prevailing the population with similar social characteristics as men, young people and those of low socioeconomic level.