Profile of Tuberculosis Deaths by Mesoregion in the State of Pará from 2012 to 2022: An Ecological Study

Introduction: Tuberculosis (TB) is an infection caused by bacteria from the Mycobacterium tuberculosis complex, transmitted through airborne aerosols, released during coughing, talking, or sneezing. Despite advancements in TB control and the availability of established treatments for over 40 years, there are still ten million new cases, and 1.5 million deaths reported annually worldwide. Methods: A descriptive and ecological study was performed on all TB-related deaths reported between 2010 and 2022, in Pará, Brazil. Data were obtained from Notifiable diseases Information System. The study have analyzed clinical, epidemiological and sociodemographic characteristics, as well as geographical and statistical trends in mortality, using binary logistic regression. Results: A total of 1,253 TB-related deaths were reported in Pará. There was a significant increasing trend in the mortality rate, with the highest value observed in the metropolitan mesoregion. The mean age was 52.1 years, most were male, brown, without elementary education and lived in the urban area. New TB cases were the most frequently recorded, with the pulmonary clinical form accounting for 84% of cases and 15.5% of cases reported from alcoholism. The most common diagnosis was sputum smear microscopy, however, follow-up sputum smear microscopies were infrequently and directly observable treatment was rarely performed (19.2%). The multivariate analysis of deaths by mesoregion revealed significant differences with each mesoregion exhibiting distinct contributing variables. Conclusions: Our results show the need for epidemiological surveillance professionals to implemente different surveillance measures and strategies for each mesoregion. Strengthening municipal healthcare system is a critical step to ensure early diagnosis and appropriate treatment for each clinical case. In addition, public policies should aim to improve socio-environmental and economic conditions addressing regional disparities to better serve the community.