Spatiotemporal analysis of tuberculosis incidence on the border between Brazil and Argentina: a time series study, 2009-2021

Objective To analyze tuberculosis cases in the international border region between the state of Santa Catarina, Brazil, and the province of Misiones, Argentina, from 2009 to 2021. Methods This was a time series study with geocoding of the average tuberculosis incidence rates of reported tuberculosis cases. Choropleth maps were plotted to identify the spatial distribution pattern and verify changes between the pre-COVID-19 pandemic period (2009 to 2019) and the full study period (2009 to 2021). Global and local Moran indices were used for spatial analyses, and segmented linear regression using the joinpoint regression method was employed for temporal analysis. Results We identified a heterogenous tuberculosis spatial distribution pattern, positive spatial autocorrelation in both periods (Moran's index 0.177 and 0.178; p-value 0.020), presence of spatial clusters and non-significant changes in temporal trends, were not significant, average annual percentage change was 4.0 and the 95% confidence intervals ranged from -1.7 to 10.0. There was no change in case recording during the COVID-19 pandemic. Being adult and of the male sex were predominant characteristics of the patients. Conclusion No significant changes in the temporal trend of incidence were detected, but spatial clusters of the high-high type (municipality and neighboring areas with high incidence) were located in Argentina and low-low clusters (municipalities and neighboring areas with low incidence) in Brazil.