Clinical and epidemiological characteristics of tuberculosis and HIV coinfection and the association with the Human Development Index in Mato Grosso do Sul State, Brazil

Abstract

OBJECTIVES:

To verify the epidemiological aspects of tuberculosis (TB) and HIV coinfection in Mato Grosso do Sul State, Brazil, and the association with the Human Development Index (HDI).

MATERIALS AND METHODS:

This is a descriptive ecological study based on cases of TB and HIV coinfection reported between 2004 and 2013, and the municipalities HDI in 2010. Sociodemographic and clinical indicators of the cases of TB/HIV coinfection were used. Poisson logistic analysis was conducted in order to test the association between the percentage of TB/HIV coinfection and the municipalities HDI; Moran's index was calculated to identify the existence of spatial autocorrelation.

RESULTS:

In the study period, 10,179 TB cases were reported, of which 988 (9.7%) presented positive anti-HIV serology. For 2,985 (29.3%) of notified cases, the serological test was not performed. TB/HIV coinfection cases predominantly occurred in males (68.9%), with low educational level (64.0%), and in the pulmonary clinical form (69.5%). Cure rate was 47.3%, treatment dropout rate was 10.5%, and TB death rate was 7.7%. Spatial analysis using global Moran's index showed the existence of spatial autocorrelation (p < 0.05), agreeing with the result of Poisson regression analysis.

CONCLUSION:

The association between cases of TB/HIV coinfection and HDI in areas with higher population density indicates the need to adopt specific strategies according to the characteristics of each locality.