Dados do Trabalho

Título

TPT partial recovery in Brazil after pandemic drawback

Introdução

Brazil was heavily hit by COVID-19 both with death polls (3rd highest globally) and economically, with absence of a centralized Federal Government response. TB notifications decreased in 2020, but partial recovery was observed in 2021. We have previously shown a severe (93%) reduction in TPT notifications in the 5 Brazilian cities with more than 1000 notifications in 2021 (https://doi.org/10.1016/j.lana.2023.100444). We hypothesized TPT would also recover.

Objetivo (s)

This study aims to update the analysis carried out in 2022 of TPT notifications carried out in Brazil in cities with more than 1,000 notifications in the period from 2019 to 2022.

Material e Métodos

We updated the previous analysis adding other cities that present more than a thousand notifications until 2022. Data aggregated by 2-week periods were extracted from the “IL-TB” information system. Biweekly percentage change (BPC) notifications until October-2022 and outcomes until July- 2022 (in the 2-weeks of TPT initiation) were analyzed using Joinpoint Software. The Wilcoxon-test, the T-test and General linear model (GLM) were used to analyze overall changes in time series.

Resultados e Conclusão

A total of 39,701 notifications in 11 cities were included, 66% from São Paulo and Rio de Janeiro. We found a significant increase of TPT notifications in the beginning of 2021 (BPC range 1.4-49.6), with sustained progression (overall 35% increase) in 7/11 cities (non-significant increase in 3 and non-significant decrease in 1). Overall, median completion rates were 66% (with a 9% increase from 2021 to 2022). In most cities, there was a gradual and steady non-significant decrease of treatment completion rates, except for Rio de Janeiro and Manaus were a BPC of 1.5 and 1.2, respectively was followed by a sustained increase.

Notifications and completion proportions of TPT were heterogeneous, reflecting the heterogeneity in local response to the pandemic. Overall, notifications recovered, and the sharp 2021 decrease previously reported is no longer observed, reflecting delays in reporting. Reduction in completion rates in some cities may reflect delays in reporting may. The overall recovery is an incentive to scale up prescription.

Palavras-chave

SARS-CoV-2, coronavirus, tuberculosis, isoniazid, rifampicin, rifampetin, syndemic