Vulnerable territories to tuberculosis-diabetes mellitus comorbidity in a northeastern Brazilian scenario
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.
Copyright (c) 2022 Giana Gislanne da Silva de Sousa, Mellina Yamamura, Márcio Flávio Moura de Araújo , Antônio Carlos Vieira Ramos , Ricardo Alexandre Arcêncio , Ana Cristina Pereira de Jesus Costa , Livia Maia Pascoal , Floriacy Stabnow Santos, Maria Aparecida Alves de Oliveira Serra, Iolanda Graepp Fontoura, Hamilton Leandro Pinto de Andrade, Livia Fernanda Siqueira Santos , Jaisane Santos Melo Lobato , Cláudia Regina de Andrade Arrais Rosa , Marcelino Santos Neto
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).