Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021

The Lancet Infectious Diseases, Journal Year: 2024, Volume and Issue: 24(7), P. 698 - 725

Published: March 19, 2024

Summary

Background

Global evaluations of the progress towards WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% have not been age specific. We aimed to assess global, regional, national-level burdens trends in tuberculosis its risk factors across five separate groups, from 1990 2021, report age-specific between 2015 2020.

Methods

used Burden Diseases, Injuries, Risk Factors Study 2021 (GBD 2021) analytical framework compute estimates for 204 countries territories (1990–2021 inclusive). quantified among individuals without HIV co-infection using 22 603 site-years vital registration data, 1718 verbal autopsy 825 sample-based 680 surveillance 9 minimally invasive tissue sample (MITS) diagnoses data as inputs into Cause Death Ensemble modelling platform. Age-specific deaths were established with a population attributable fraction approach. analysed all available population-based sources, including prevalence surveys, annual case notifications, tuberculin mortality, DisMod-MR 2.1 produce internally consistent incidence, prevalence, mortality. also estimated that is independent combined effects three (smoking, alcohol use, diabetes). As secondary analysis, we examined potential impact COVID-19 pandemic by comparing expected deaths, modelled 2019 observed cause-specific data.

Findings

9·40 million (95% uncertainty interval [UI] 8·36 10·5) incident cases 1·35 (1·23 1·52) due 2021. At global level, all-age rate declined 6·26% (5·27 7·25) (the strategy evaluation period). 15 achieved 20% decrease 2020, eight which western sub-Saharan Africa. When stratified age, rates decreased 16·5% (14·8 18·4) children younger than 5 years, 16·2% (14·2 17·9) those aged 5–14 6·29% (5·05 7·70) 15–49 5·72% (4·02 7·39) 50–69 8·48% (6·74 10·4) 70 years older, 11·9% (5·77 17·0) 17 attained 35% reduction most eastern Europe (six countries) central (four countries). There was variable age: 35·3% (26·7 41·7) 29·5% (25·5 34·1) 15·2% (10·0 20·2) 7·97% (0·472 14·1) 3·29% (–5·56 9·07) older. Removing would reduced number 1·39 (1·28 1·54) 1·00 (0·703 1·23) representing 36·5% (21·5 54·8) compared 2015. 41 included our analysis 20 In 50 900 CI 49 700 52 400) ages, an 45 500 corresponding 5340 (4070 6920) fewer deaths; 39 600 (38 300 100) ages 000 657 (–713 2180) deaths.

Interpretation

Despite accelerated reducing burden past decade, world did attain first The pace decline has unequal respect older adults (ie, >50 years) having slowest progress. refine their national programmes recalibrate achieving 2035 targets, they could consider learning strategies milestones, well targeted interventions improve outcomes groups.

Funding

Bill & Melinda Gates Foundation.

Language: Английский

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The impact of the COVID-19 pandemic in tuberculosis preventive treatment in Brazil: a retrospective cohort study using secondary data

The Lancet Regional Health - Americas, Journal Year: 2023, Volume and Issue: 19, P. 100444 - 100444

Published: Feb. 10, 2023

Disruptions in tuberculosis services have been reported around the world since emergence of COVID-19 pandemic. However, pandemic's effect on preventive treatment (TPT) has poorly explored. We compared TPT-notified prescriptions and outcomes before during pandemic Brazil. Retrospective cohort using secondary data from Brazilian TPT information system five cities with over 1000 notifications. The number was analysed 6 months after healthcare workers' training, 2018, to July 2021. proportion by date initiation up end 2020, as most started 2021 were still unknown Joinpoint regression used evaluate trends. 14,014 included, São Paulo (8032) Rio de Janeiro (3187). Compared same epidemiological weeks 2019, prescribed 2020 increased (82%) (14%) decreased Recife (65%), Fortaleza (31%) Manaus (44%). In 2021, however, there a 93% reduction all cities. completed remained constant (median = 74%). Brazil associated dramatic decrease Treatment adherence constant, suggesting that health able keep people but did not perform well providing opportunities for enter care. Efforts are needed expand access TPT. Ministry Science, Technology Innovation, CNPq.

Language: Английский

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Impact of the COVID-19 Pandemic Surveillance of Visceral Leishmaniasis in Brazil: An Ecological Study

Infectious Disease Reports, Journal Year: 2024, Volume and Issue: 16(1), P. 116 - 127

Published: Feb. 9, 2024

The aim of the study was to assess impact COVID-19 pandemic on notification new VL cases in Brazil 2020. It is an ecological and time-series (2015–2020) with spatial analysis techniques, whose units were 5570 Brazilian municipalities. population consisted all recorded between 2015 P-score calculated estimate percentage variation cases. Global local univariate Moran’s Indices retrospective space–time scan statistics used analyses, respectively. expected that there would be 3627 2020, but 1932 reported (−46.73%). All regions presented a negative registration cases, Southeast (−54.70%), North (−49.97%), Northeast (−44.22%) standing out. There dependence disease nationwide both periods, before during first year pandemic. significant reduction incidence These findings reinforce need for better preparedness health system, especially situations epidemics.

Language: Английский

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Impact of the COVID-19 pandemic on the actions of the Schistosomiasis Control Program in an endemic area in Northeastern Brazil

Acta Tropica, Journal Year: 2023, Volume and Issue: 240, P. 106859 - 106859

Published: Feb. 11, 2023

Language: Английский

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Global epidemiology of Mycobacterium tuberculosis lineage 4 insights from Ecuadorian genomic data

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: Jan. 30, 2025

Tuberculosis is a global public health concern, and understanding Mycobacterium tuberculosis transmission routes genetic diversity of M. crucial for outbreak control. This study aimed to explore the genomic epidemiology in Ecuador by analyzing 88 local isolates 415 genomes from 19 countries within Euro-American lineage (L4). Our results revealed significant among isolates, particularly genes related protein processing, carbohydrate metabolism, lipid xenobiotic biodegradation metabolism. The population structure analysis showed that sub-lineages 4.3.2/3 (35.4%), 4.1.2.1 (22.7%), 4.4.1 (12.7%), 4.1.1. (10.7%) were most prevalent. Phylogenetic network analyses suggest these circulating share ties with other continents, implying historical ongoing intercontinental events. findings underscore importance integrating data into strategies control enhanced surveillance essential mitigating spread tuberculosis. provides comprehensive framework future epidemiological investigations measures targeting L4 Ecuador.

Language: Английский

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Spacetime modeling of mortality by infectious and parasitic diseases in Brazil: a 20-year ecological and population-based study

Therapeutic Advances in Infectious Disease, Journal Year: 2025, Volume and Issue: 12

Published: Jan. 1, 2025

Background: Infectious and parasitic diseases (IPDs) encompass a broad range of illnesses predominantly associated with poverty. They are more prevalent in low- middle-income countries, including Brazil, where they continue to be among the leading causes mortality. Objective: This study aims analyze spatiotemporal dynamics mortality due IPDs Brazil from 2000 2019. Methods: We conducted an ecological using data on by Brazilian Mortality Information System. applied segmented log-linear regression model assess temporal trends. For spatial analysis, we used local empirical Bayesian estimator Moran indices. Retrospective scan statistics were performed Poisson Probability Distribution Model. Results: Between 2019, there 2,155,513 deaths related Brazil. The death included acute respiratory infections ( n = 1,130,069; 52.49%), septicemia 289,817; 13.46%), human immunodeficiency virus/acquired syndrome 232,892; 10.82%), tuberculosis 104,121; 4.84%), neglected tropical such as Chagas disease 94,788; 4.40%) schistosomiasis 10,272; 0.48%). An increasing trend rate was observed across all its regions. Additionally, our identified high-risk clusters Southeast Northeast Conclusion: remains significant public health concern Our findings underscore urgent need for comprehensive intersectoral policies. These policies should focus greater allocation resources investments most critical areas, aiming significantly reduce number deaths, particularly vulnerable

Language: Английский

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An interrupted time series study of the leprosy case detection in Brazil after the COVID-19 pandemic

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: March 21, 2025

COVID-19 pandemics affected several health systems processes, including leprosy care. This study aimed to estimate the impact of pandemic on case detection rate in Brazil from 2017 2022. Data was retrieved Sinan, a Brazilian notification system, and monthly overall population individuals under 15 years age were main outcomes. The series interrupted February 2020, when public emergency declared Brazil. data analysed via Prais–Winsten regression. Over 72 months analysed, led an immediate 0.55 reduction (95% CI 0.48–0.62) rate, with subsequent increase 1.01 1.00–1.02). For age, caused 0.48 0.40–0.57), followed by 1.01–1.02) after onset pandemic. Subnational analysis revealed that most federative units trend for but high heterogeneity observed regarding age. Therefore, it is urgent target strategies minimize delayed diagnosis long-term consequences leprosy.

Language: Английский

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Epidemiological Scenario of American Trypanosomiasis and Its Socioeconomic and Environmental Relations, Pará, Eastern Brazilian Amazon

Tropical Medicine and Infectious Disease, Journal Year: 2025, Volume and Issue: 10(4), P. 88 - 88

Published: March 28, 2025

Chagas disease is a serious public health problem worldwide. In Brazil, the state of Pará has largest number reported cases. This article analyzes spatial distribution this and its relationship with socioeconomic, environmental, policy variables in three mesoregions from 2013 to 2022. ecological study used secondary data obtained official Brazilian agencies. Spatial analysis was carried out using flow, kernel, bivariate global Moran techniques expressed thematic maps. A total 3664 cases were confirmed, highest being northeast Pará. seasonal pattern disease, an epidemiological profile similar other diseases Amazon region, dependence between prevalence socioeconomic indicators observed. The most intense movement patients for treatment Belém metropolitan mesoregion, which majority services professionals. showed inhomogeneous terms distribution, direct areas higher those human clusters. socioenvironmental origins transcend mesoregion boundaries stem historically unsustainable development model Amazon.

Language: Английский

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Reduced HIV/AIDS diagnosis rates and increased AIDS mortality due to late diagnosis in Brazil during the COVID-19 pandemic

Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)

Published: Dec. 27, 2023

Abstract The COVID-19 pandemic has severely affected global health, leading to the suspension of numerous routine healthcare services and posing challenges in efforts control other diseases, such as HIV/AIDS. This study aimed assess impact on HIV/AIDS diagnoses mortality rates Brazil during 2020 2021. percentage change was calculated determine whether there an increase or decrease mortality, considering average numbers from last 5 years. Additionally, a Joinpoint regression model interrupted time series analysis were applied trends before after onset pandemic. Lastly, choropleth maps prepared. We observed reduction 22.4% (2020) 9.8% (2021) diagnosis Brazil. Conversely, significant late AIDS deaths (6.9%) 2021 (13.9%), with some states showing over 87%. Decreasing identified Brazil, especially Southeast South regions, then stabilized including Along dissemination COVID-19, deaths, signaling serious strategies Therefore, we highlight need for continuous both that is, maintaining regular health even crisis situations.

Language: Английский

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The COVID-19 pandemic impacted the activities of the Schistosomiasis Control Program in Brazil: is the goal of controlling the disease by 2030 at risk?

Transactions of the Royal Society of Tropical Medicine and Hygiene, Journal Year: 2024, Volume and Issue: unknown

Published: May 15, 2024

Abstract Background Schistosomiasis continues to represent a serious public health problem in Brazil. With the coronavirus disease 2019 (COVID-19) pandemic, several control strategies were suspended, probably compromising goals of eradicating country. We aimed assess impact COVID-19 pandemic on Control Program (PCE) actions all endemic states Methods performed an ecological study using spatial analysis techniques. The PCE variables assessed population surveyed, number Kato–Katz tests, positive cases schistosomiasis and percentage treated between 2015 2021. percent change was calculated verify if there increase or decrease 2020 2021, along with time trend analyses provided by Joinpoint model. Spatial distribution maps elaborated considering change. Results surveyed decreased (−65.38%) 2021 (−37.94%) across There proportional reduction tests (2020, −67.48%; −40.52%), −71.16%; −40.5%) −72.09%; −41.67%). Time showed decreasing most variables. Conclusions activities impacted Brazil must be urgently reviewed, focusing investments areas.

Language: Английский

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