Tuberculose e coinfecção com HIV no Sul de Moçambique (2012-2020): um estudo de série temporal

Abstract

Tuberculosis-TB is still a global health problem, especially in Mozambique, where the disease burden and its association with the human immunodeficiency virus (HIV) is still high. This study aimed to analyze the time trends of reported cases of tuberculosis and TB coinfection with HIV in southern Mozambique in the period 2012-2020. Data for this study were collected from the former provincial tuberculosis database and the current Online Monitoring and Evaluation Information System-SISMA. The incidence and mortality coefficients of tuberculosis and co-infection of TB with HIV were analyzed. All-time series analyzes were performed using the R statistical program. A total of 62,226 TB cases were included in the study period from 2012 to 2022. There was a growing trend in the incidence of new cases, (with an increase of 74% between 2012 and 2020) and of all forms of TB (cases new cases treatments and retreatments) with an increase of 70% between 2012 and 2020. Regarding the incidence rate of TB and HIV coinfection cases, there was a downward trend, especially in the last two years (with a 13% reduction between 2012 and 2020). There was an increase in the trend of HIV testing in TB patients (except in the last two where there was decrease, between 2018 and 2020), as well as an increase in the greater use of ART in TB/HIV+ cases, as well as with a decrease in the rate of TB and HIV coinfection over the years. There was also a progressive trend in the treatment success rate, the reduction of the default treatment rate, and the case fatality ratio from tuberculosis, indicating that the province's TB services were improving. Unfavorable outcomes, including deaths, were more common among TB-HIV coinfection cases when compared to HIV-negative TB infection cases (p-value=<0.05). Through time series analysis of the coefficient of incidence of new cases and of all forms of TB, our study showed a seasonal variation, with the peak of TB notification at the end of winter (concentrated in the 3rd quarter of each year). The results obtained show improvements in the quality of the data and the trends of TB indicators and TB-HIV coinfection over the years in the researched area, even so, below the WHO goals.