Vulnerable territories to tuberculosis-diabetes mellitus comorbidity in a northeastern Brazilian scenario

  • Giana Gislanne da Silva de Sousa Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil https://orcid.org/0000-0003-1493-1706
  • Mellina Yamamura Department of Nursing, Federal University of São Carlos, São Paulo, Brazil https://orcid.org/0000-0001-5228-8788
  • Márcio Flávio Moura de Araújo Oswaldo Cruz Foundation, Eusébio, Ceará, Brazil https://orcid.org/0000-0001-8832-8323
  • Antônio Carlos Vieira Ramos University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil https://orcid.org/0000-0002-7862-1355
  • Ricardo Alexandre Arcêncio University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil https://orcid.org/0000-0003-4792-8714
  • Ana Cristina Pereira de Jesus Costa Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0001-7757-8183
  • Livia Maia Pascoal Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil https://orcid.org/0000-0003-0876-3996
  • Floriacy Stabnow Santos Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0001-7840-7642
  • Maria Aparecida Alves de Oliveira Serra Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0003-0952-9560
  • Iolanda Graepp Fontoura Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0002-9201-480X
  • Hamilton Leandro Pinto de Andrade Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0002-0796-0464
  • Livia Fernanda Siqueira Santos Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0001-9492-0091
  • Jaisane Santos Melo Lobato Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0002-3610-7753
  • Cláudia Regina de Andrade Arrais Rosa Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil https://orcid.org/0000-0003-1683-8855
  • Marcelino Santos Neto Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil https://orcid.org/0000-0002-6105-1886
Keywords: tuberculosis, diabetes, comorbidity, georeferencing

Abstract

Introduction: Epidemiological investigations on tuberculosis-diabetes comorbidity using spatial analysis should be encouraged towards a more comprehensive view of the health of individuals affected by such comorbidity in different contexts. This study analyzes the territories vulnerable to tuberculosis-diabetes comorbidity in a municipality in northeastern Brazil using spatial analysis techniques.

Methods: An ecological study was carried out in Imperatriz, Maranhão, Brazil. Tuberculosis-diabetes cases reported in the Brazilian Notifiable Diseases Information System between 2009 and 2018 were analyzed. Kernel density estimation and spatial scanning techniques were used to identify the areas with the greatest occurrence of spatial clusters.

Results: A heterogeneous spatial distribution was found, ranging from 0.00 to 4.12 cases/km2. The spatial scanning analysis revealed three high-risk spatial clusters with statistical significance (p < 0.05), involving eleven strictly urban sectors with a relative risk of 4.00 (95% CI: 2.60–6.80), 5.10 (95% CI: 2.75–7.30), and 6.10 (95% CI: 3.21–8.92), indicating that the population living in these areas had a high risk of tuberculosis-diabetes comorbidity.

Conclusions: The highest concentration of cases/km2, as well as risk clusters, were found in areas with high circulation of people and socio-economic and environmental vulnerabilities. Such findings reinforce the need for public health interventions to reduce social inequalities.

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Author Biographies

Mellina Yamamura, Department of Nursing, Federal University of São Carlos, São Paulo, Brazil

Department of Nursing, Federal University of São Carlos, São Paulo, Brazil

Márcio Flávio Moura de Araújo, Oswaldo Cruz Foundation, Eusébio, Ceará, Brazil

Oswaldo Cruz Foundation, Eusébio, Ceará, Brazil

Antônio Carlos Vieira Ramos, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil

University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil

Ricardo Alexandre Arcêncio, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil

University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil

Ana Cristina Pereira de Jesus Costa, Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Livia Maia Pascoal, Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil

Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil

Floriacy Stabnow Santos, Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Maria Aparecida Alves de Oliveira Serra, Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Iolanda Graepp Fontoura, Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Hamilton Leandro Pinto de Andrade, Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Livia Fernanda Siqueira Santos, Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Health and Technology Graduate Program, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Jaisane Santos Melo Lobato, Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Cláudia Regina de Andrade Arrais Rosa, Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Center of Social Sciences, Health and Technology, Federal University of Maranhão, Imperatriz, Maranhão, Brazil

Marcelino Santos Neto, Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil

Nursing Graduate Program, Federal University of Maranhão, São Luís, Maranhão, Brazil

Published
2022-05-30
How to Cite
1.
da Silva de SousaGG, Yamamura M, Moura de AraújoMF, Vieira RamosAC, Arcêncio RA, Pereira de Jesus CostaAC, Maia PascoalL, Stabnow SantosF, Alves de Oliveira SerraMA, Graepp FontouraI, Pinto de AndradeHL, Siqueira SantosLF, Santos Melo LobatoJ, de Andrade Arrais RosaCR, Santos NetoM (2022) Vulnerable territories to tuberculosis-diabetes mellitus comorbidity in a northeastern Brazilian scenario. J Infect Dev Ctries 16:813-820. doi: 10.3855/jidc.15797
Section
Original Articles

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