Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.

<h4>Background</h4>Tuberculosis (TB) in migrants is of concern to health authorities worldwide and is even more critical in Brazil, considering the country´s size and long land borders. The aim of the study was to identify critical areas in Brazil for migrants diagnosed with TB and to de...

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Autores principales:	Ricardo Alexandre Arcêncio, Thaís Zamboni Berra, Nahari de Faria Marcos Terena, Matheus Piumbini Rocha, Tatiana Ferraz de Araújo Alecrim, Fernanda Miye de Souza Kihara, Keila Cristina Mascarello, Carolina Maia Martins Sales, Ethel Leonor Noia Maciel
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/97cdcc5863344847b8c97fc039f9bb09
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spelling	oai:doaj.org-article:97cdcc5863344847b8c97fc039f9bb092021-12-02T20:07:12ZSpatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.1932-620310.1371/journal.pone.0252712https://doaj.org/article/97cdcc5863344847b8c97fc039f9bb092021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252712https://doaj.org/toc/1932-6203<h4>Background</h4>Tuberculosis (TB) in migrants is of concern to health authorities worldwide and is even more critical in Brazil, considering the country´s size and long land borders. The aim of the study was to identify critical areas in Brazil for migrants diagnosed with TB and to describe the temporal trend in this phenomenon in recent years.<h4>Methods</h4>This is an ecological study that used spatial analysis and time series analysis. As the study population, all cases of migrants diagnosed with TB from 2014 to 2019 were included, and Brazilian municipalities were considered as the unit of ecological analysis. The Getis-Ord Gi* technique was applied to identify critical areas, and based on the identified clusters, seasonal-trend decomposition based on loess (STL) and Prais-Winsten autoregression were used, respectively, to trace and classify temporal trend in the analyzed series. In addition, several municipal socioeconomic indicators were selected to verify the association between the identified clusters and social vulnerability.<h4>Results</h4>2,471 TB cases were reported in migrants. Gi* analysis showed that areas with spatial association with TB in immigrants coincide with critical areas for TB in the general population (coast of the Southeast and North regions). Four TB clusters were identified in immigrants in the states of Amazonas, Roraima, São Paulo, and Rio de Janeiro, with an upward trend in most of these clusters. The temporal trend in TB in immigrants was classified as increasing in Brazil (+ 60.66% per year [95% CI: 27.21-91.85]) and in the clusters in the states of Amazonas, Roraima, and Rio de Janeiro (+1.01, +2.15, and + 2.90% per year, respectively). The cluster in the state of São Paulo was the only one classified as stationary. The descriptive data on the municipalities belonging to the clusters showed evidence of the association between TB incidence and conditions of social vulnerability.<h4>Conclusions</h4>The study revealed the critical situation of TB among migrants in the country. Based on the findings, health authorities might focus on actions in regions identified, stablishing an intensive monitoring and following up, ensuring that these cases concluded their treatment and avoiding that they could spread the disease to the other regions or scenarios. The population of migrants are very dynamic, therefore strategies for following up them across Brazil are really urgent to manage the tuberculosis among international migrants in an efficient and proper way.Ricardo Alexandre ArcêncioThaís Zamboni BerraNahari de Faria Marcos TerenaMatheus Piumbini RochaTatiana Ferraz de Araújo AlecrimFernanda Miye de Souza KiharaKeila Cristina MascarelloCarolina Maia Martins SalesEthel Leonor Noia MacielPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252712 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ricardo Alexandre Arcêncio Thaís Zamboni Berra Nahari de Faria Marcos Terena Matheus Piumbini Rocha Tatiana Ferraz de Araújo Alecrim Fernanda Miye de Souza Kihara Keila Cristina Mascarello Carolina Maia Martins Sales Ethel Leonor Noia Maciel Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.
description	<h4>Background</h4>Tuberculosis (TB) in migrants is of concern to health authorities worldwide and is even more critical in Brazil, considering the country´s size and long land borders. The aim of the study was to identify critical areas in Brazil for migrants diagnosed with TB and to describe the temporal trend in this phenomenon in recent years.<h4>Methods</h4>This is an ecological study that used spatial analysis and time series analysis. As the study population, all cases of migrants diagnosed with TB from 2014 to 2019 were included, and Brazilian municipalities were considered as the unit of ecological analysis. The Getis-Ord Gi* technique was applied to identify critical areas, and based on the identified clusters, seasonal-trend decomposition based on loess (STL) and Prais-Winsten autoregression were used, respectively, to trace and classify temporal trend in the analyzed series. In addition, several municipal socioeconomic indicators were selected to verify the association between the identified clusters and social vulnerability.<h4>Results</h4>2,471 TB cases were reported in migrants. Gi* analysis showed that areas with spatial association with TB in immigrants coincide with critical areas for TB in the general population (coast of the Southeast and North regions). Four TB clusters were identified in immigrants in the states of Amazonas, Roraima, São Paulo, and Rio de Janeiro, with an upward trend in most of these clusters. The temporal trend in TB in immigrants was classified as increasing in Brazil (+ 60.66% per year [95% CI: 27.21-91.85]) and in the clusters in the states of Amazonas, Roraima, and Rio de Janeiro (+1.01, +2.15, and + 2.90% per year, respectively). The cluster in the state of São Paulo was the only one classified as stationary. The descriptive data on the municipalities belonging to the clusters showed evidence of the association between TB incidence and conditions of social vulnerability.<h4>Conclusions</h4>The study revealed the critical situation of TB among migrants in the country. Based on the findings, health authorities might focus on actions in regions identified, stablishing an intensive monitoring and following up, ensuring that these cases concluded their treatment and avoiding that they could spread the disease to the other regions or scenarios. The population of migrants are very dynamic, therefore strategies for following up them across Brazil are really urgent to manage the tuberculosis among international migrants in an efficient and proper way.
format	article
author	Ricardo Alexandre Arcêncio Thaís Zamboni Berra Nahari de Faria Marcos Terena Matheus Piumbini Rocha Tatiana Ferraz de Araújo Alecrim Fernanda Miye de Souza Kihara Keila Cristina Mascarello Carolina Maia Martins Sales Ethel Leonor Noia Maciel
author_facet	Ricardo Alexandre Arcêncio Thaís Zamboni Berra Nahari de Faria Marcos Terena Matheus Piumbini Rocha Tatiana Ferraz de Araújo Alecrim Fernanda Miye de Souza Kihara Keila Cristina Mascarello Carolina Maia Martins Sales Ethel Leonor Noia Maciel
author_sort	Ricardo Alexandre Arcêncio
title	Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.
title_short	Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.
title_full	Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.
title_fullStr	Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.
title_full_unstemmed	Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.
title_sort	spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in brazil.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/97cdcc5863344847b8c97fc039f9bb09
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Spatial clustering and temporal trend analysis of international migrants diagnosed with tuberculosis in Brazil.

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