Variáveis socioeconômicas: promoção de saúde e indicadores epidemiológicos de tuberculose e do vírus da imunodeficiência humana

Abstract

Introduction: In 2014, 9.6 million new cases of tuberculosis (TB) were estimated worldwide, 12% of which were in people coinfected with the human immunodeficiency virus (HIV). In Brazil there were 67,966 new cases and in 2015 the country prepared the "National Plan for Ending Tuberculosis as a Public Health Problem", based on the precepts and guidelines of health promotion in order to improve the living conditions of the population. Objective: The objective of the present study was to analyze the relationship between the epidemiological indicators of TB and the socioeconomic variables related to the fields of action of health promotion in Brazilian capitals. Material and methods: This is an ecological study using Secondary data, which seeks to associate knowledge in the areas of tuberculosis and health promotion in Brazilian capitals. To describe the epidemiological indicators, the Mortality Information System (SIM), the Notification Disease Information System (SINAN) and the Epidemiological Bulletins of the Ministry of Health were used for both TB and HIV. The variables used were: number of new cases, incidence coefficient, and mortality rate. For the analysis of socioeconomic aspects, the municipal human development index, infant mortality, urbanization rate, housing conditions, aging index, dependency ratio, poverty and Gini. Results and Discussion: The disease had a heterogeneous distribution throughout the country and was more frequent in males, in the age group between 20 and 59 years old and living in large urban centers. Among the Brazilian capitals, Porto Alegre recorded the highest incidence and mortality rate for both TB and HIV in the period studied, and the lowest rates were registered in Brasília. The associations between the incidence of TB and the municipal human development index (IDHM) indicate that some Brazilian capitals, such as Manaus, presented high incidence and low HDI and others, such as Brasília, low incidence and high HDI. Some capitals, such as Palmas, presented low HDI and low incidence, while others, like Porto Alegre, presented high HDI and high incidence. As for the association between the incidence of TB and access to basic health and sanitation services, despite the wide access to these services, their quality is questioned, reflecting in the worst indicators of the disease in the population. There has been an increasing number of registered cases of TB in people aged 60 years or older, suggesting that senior citizens should be considered for disease control actions. With regard to social inequality and poverty, both have changed over the years, with regional differences associated with increased incidence and mortality from tuberculosis. Conclusion: The results showed that the capitals failed to progress in reducing the incidence and mortality coefficients for TB, and that the desired changes depend on concrete actions aimed at reducing poverty, investments in education and guaranteeing the provision of health services. Sufficient quantity and quality.