Epidemiology of Meningoencephalic Diseases Caused by Tuberculosis in Brazil in the 21st Century
Pedro Henrique Gonzales1, Patrick Cristian Lima Orihuela1, Valéria Salas1, Leonardo Moraes Armesto1
1Universidade Municipal de São Caetano do Sul
Objective:
This study aimed to analyze the epidemiological profile and clinical follow-up of individuals with TBME
Background:
Tuberculosis, caused by Mycobacterium tuberculosis, remains one of the major endemic infectious diseases in Brazil in the 21st century. In some cases, the infection spreads hematogenously from the primary pulmonary focus to other organs or manifests exclusively as extrapulmonary disease. Vulnerable populations, such as homeless individuals, people deprived of liberty, those with diabetes, and persons living with HIV/AIDS, are at greater risk of developing extrapulmonary meningoencephalic tuberculosis (TBME). This form of TB is associated with high mortality and significant neurological morbidity, including seizures, cognitive impairment, and hydrocephalus.
Design/Methods:
A descriptive, retrospective cohort analysis was conducted using data from the DATASUS(TABNET) database. Tuberculosis indicators were collected from 2001-2024 for the following variables: region, age, sex, education, homelessness, incarceration, low educational level, AIDS, treatment abandonment, and mortality.
Results:
Data from TBME patients obtained through DATASUS revealed important associations between specific factors and disease onset. Among the 19,534 reported cases, 64.4% (12,578) were men, 45.8% (8,943) were from the Southeast region, 50.8% (9,920) were HIV-positive, 43.9% (8,578) were aged 20–39 years, 35% (6,884) identified as mixed race, 9.8% (1,906) abandoned treatment, and 5.7% (1,106) died directly from tuberculosis. These findings indicate that analyzing multiple social determinants enables the identification of a common underlying issue—insufficient public health response in specific contexts, particularly regarding treatment adherence, as reflected by the substantial rate of patient dropout.
Conclusions:
Furthermore, the observed increase in affected populations in certain regions highlights the urgency of targeted interventions. Therefore, the implementation of public health strategies aimed at raising awareness among healthcare professionals and the general population about the severity of TBME and the critical importance of consistent, high-quality follow-up care in Brazil is essential.
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