Tuberculosis meningoencephalitis in São Paulo from 2001 to 2022: an epidemiological study

Introduction: Tuberculosis (TB) is the most prevalent mycobacteriosis in Brazil. Among its extrapulmonary manifestations, one of the most worrying is meningoencephalitis (ME), which is characterized by inflammation of the brain parenchyma and meninges due to infection by the TB bacillus, leading to clinical conditions such as headache, decreased consciousness, intracranial hypertension and coma. Objectives: To describe the epidemiological profile of confirmed cases of ME due to TB in the state of São Paulo between the years 2001 to 2022. Methods: This work is an epidemiological investigation study of confirmed cases of ME due to TB between the years 2001 to 2022. Data were collected from the Notifiable Diseases Information System of DATASUS. Data were organized and analyzed using the Jamovi® statistical software. Results: 418,553 TB cases were confirmed in São Paulo during the period. In this group 5,129 (1.2% of TB cases) had a confirmed diagnosis of ME. An average of 233 (±36.8) cases occur in an upward trend until 2009, when there was an inflection and a downward trend until 2022. Among cases of ME due to TB, data indicates that 64.4% occurred in men, the most prevalent age group was 20 to 39 years old (45.7% of the total) and the most prevalent skin color was white(34.2% of the patients). Another important correlation was the incidence of human immunodeficiency virus (HIV), amounting up to 53.3% of patients with these concurrent diseases. In regards to the final outcomes among those diagnosed with ME due to TB, there were 1,828 deaths (35.6%), of which 17.8% due to TB, and 2,285 patients were cured (44.5%). Conclusion: The results showed a dispersed annual average of cases with a downward trend from 2009 onwards. Regarding the epidemiological profile, there was a higher prevalence in men, residents of urban areas, young and with an important correlation with HIV. In conclusion, ME due to TB had a high mortality rate and a reasonable cure rate.