Análise espacial e fluxo assistencial da tuberculose em um município prioritário de Minas Gerais

Abstract

Tuberculosis persists as an important and challenging public health problem, contributing to the maintenance of inequality and social exclusion in several countries. It is one of the most prevalent diseases among people in poverty with a high mortality burden as well as HIV and malaria. The decentralization of tuberculosis control to Primary Health Care has been recommended and encouraged by the National Tuberculosis Control Program as it increases patient access to health services and offers greater adherence to treatment. The present study aims to analyze the assistance flow and the spatial distribution of tuberculosis incidence in the Urban Regions of a priority municipality, Juiz de Fora, Minas Gerais, from 2008 to 2015. Secondary data were used from Juiz de Fora Tuberculosis database (CID10 codes A15-A19), SINAN, from 2008 to 2015, in addition to data from the 2010 demographic census. The data were georeferenced, exported to a Geographic Information System and grouped by Urban Regions. Average tuberculosis incidence rate and other sociodemographic and spatial indicators were calculated. It was found that the tuberculosis incidence was 48.3 cases / 100 thousand inhabitants / year, with a heterogeneous spatial distribution, emphasizing the unbalanced involvement of tuberculosis in population groups with worse living conditions The indicators Proportion of Poor, Household Density and Aging Idex were able to explain the tuberculosis incidence atthe level of the Urban Region. Decentralization of Tuberculosis health care is not yet a reality in the municipality seeing that hospitals were responsible for more than half of tuberculosis notifications (54.0%).