Tuberculosis in Belém: a temporal analysis integrating clinical, epidemiological, operational, and climatic factors

Abstract

OBJECTIVE: To identify the temporal trend in tuberculosis (TB) incidence in Belém and describe the disease's clinical, epidemiological, operational, and climatic variables in the municipality. METHODS: This quantitative, cross-sectional epidemiological study used data on new TB cases reported to SINAN in Belém, Pará, from 2014 to 2023. Data were analyzed using descriptive statistics. Temporal trends were assessed using simple linear regression, with models selected on the basis of the highest coefficient of determination (R²). RESULTS: TB incidence in Belém fluctuated annually, falling sharply in 2020 before increasing over the final three years of the study period. The highest incidence rate was recorded in 2023. For the full period, the fitted linear equation was y = 0.9777x + 105.23, with a positive slope (0.9777), indicating an upward trend in incidence. Important tests and procedures, including culture, rapid molecular testing for TB, drug susceptibility testing, and directly observed treatment, were either underreported or not performed. No significant association was found with the climatic variables assessed. The cure rate was below the target, and treatment discontinuation remained a substantial challenge. The high proportion of fields marked "Unknown" or left blank for several variables (education, race/skin color, tests, directly observed treatment, and treatment outcome) suggests possible weaknesses in the information system. CONCLUSION: TB remains a serious public health problem in Belém, and greater investment in public policies is needed to control the disease effectively.