REPERCUSSIONS OF THE COVID-19 PANDEMIC ON TUBERCULOSIS EPIDEMIOLOGICAL INDICATORS IN A BRAZILIAN URBAN CAPITAL

Introduction/Objectives: Tuberculosis is an important public health problem globally, with Brazil among the 30 countries with the highest disease burden. It is the leading cause of mortality from a single infectious agent, surpassed only by COVID-19 between 2020 and 2022. Strongly associated with social determinants, tuberculosis has high prevalence in urban centers. The pandemic accentuated social and economic inequalities, negatively impacting tuberculosis indicators and distancing the country from the goals of the “End TB Strategy”, which aims to eliminate the disease by 2030. Therefore, this study seeks to analyze the impacts of the pandemic on tuberculosis epidemiological indicators in the municipality of São Paulo, aiming to understand the magnitude and territorial disparities of the disease. Materials and Methods: A descriptive, cross-sectional study with a quantitative approach, using a database regarding tuberculosis epidemiological indicators from 2019 to 2022. Information was divided according to the Regional Health Coordinations and collected from open-access governmental sources and from the “TBWEB” system using a standardized form. Results: The population of the city of São Paulo exceeded 11.5 million during the analyzed period, heterogeneously distributed among regions. Notifications of new tuberculosis cases were: 6,322 (2019), 5,637 (2020), 5,803 (2021), and 6,573 (2022), showing an initial drop followed by growth, surpassing the pre-pandemic level. Except for the Central region, all coordinations followed the same pattern. In contrast, there was an increase in the number of deaths ‒ from 298 deaths (2019) to 453 (2022) ‒ and in the mortality coefficient. In addition, there was an increase in treatment interruptions and a decrease in the proportion cured, reflecting worsening and progression of the disease. Conclusion: The COVID-19 pandemic negatively impacted tuberculosis control in São Paulo, accentuating social vulnerabilities and hindering access to health services. The analyzed indicators point to setbacks in disease control, and the losses suffered are reflected in the current scenario, in which tuberculosis has again taken a prominent position as the leading cause of death from an infectious agent in the country.