TEMPORAL PATTERN OF TUBERCULOSIS IN ELDERLY INDIVIDUALS WITH DIABETES MELLITUS IN BRAZIL

Título

Temporal Pattern of Tuberculosis in Elderly Individuals with Diabetes Mellitus in Brazil

Introdução

Elderly individuals with Diabetes Mellitus are at increased risk of developing tuberculosis due to immune system impairment caused by chronic hyperglycemia, which compromises inflammatory responses and macrophage function.

Objetivo

To analyze the temporal trend of confirmed tuberculosis cases in elderly individuals with Diabetes Mellitus in Brazil.

Método

This ecological study employed a temporal trend analysis. Data were collected in April 2025, covering all Brazilian states. Tuberculosis data were retrieved from the Notifiable Diseases Information System (SINAN), accessed via the Department of Informatics of the Unified Health System (DATASUS) portal. We included reported cases from 2013 to 2024 that specifically indicated a diagnosis of tuberculosis associated with Diabetes Mellitus. A simple descriptive analysis was conducted to characterize the sociodemographic profile of the cases using absolute and relative frequencies for age group, sex, and race/skin color. Time series analysis was then performed using the Joinpoint Regression Program, with 95% confidence intervals.

Resultados

A total of 32,991 confirmed cases of tuberculosis were identified. Most cases occurred among males (19,956; 60%), individuals of mixed race/skin color (15,239; 46%), and those aged 60–69 years (20,219; 61%). The joinpoint analysis showed a consistent upward trend in the North and Northeast regions throughout the study period, with annual percent changes (APC) of 6.09% and 3.37%, respectively. In the Central-West region, a significant downward trend was observed between 2022 and 2024 (-23.8%). In the Southeast, an upward trend of 6.44% per year was observed from 2015 to 2022, followed by a downward trend until 2024 (-1.97%). The South region showed a slightly decreasing trend between 2018 and 2024 (0.96%; p > 0.05).

Conclusão

The continuous rise in tuberculosis cases in the North and Northeast may reflect disparities in access to primary care, limitations in epidemiological surveillance, and greater social vulnerability. The Central-West, Southeast, and South regions exhibited more variable patterns, alternating between periods of increase and decline, which may be influenced by contextual factors such as fluctuations in health program coverage and changes in case detection strategies.

Palavras Chave

Diabetes Mellitus; Tuberculosis; Spatio-Temporal Analysis