SOCIAL DETERMINANTS AND THE TUBERCULOSIS PROFILE IN BRAZIL: POPULATIONS AT RISK (2015–2024)

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, mainly affecting the lungs, although it can involve other organs and systems, resulting in extrapulmonary TB (EPTB). TB is strongly associated with social determinants of health and with clinical conditions that compromise immunity, such as HIV, and is fueled by a Brazilian context marked by persistent regional inequalities and social vulnerabilities that sustain transmission. Therefore, this study aimed to analyze the clinical and epidemiological characteristics of TB in Brazil from 2015 to 2024. Cross-sectional, descriptive study with a quantitative approach, using data collected from the Notifiable Diseases Information System (SINAN) from 2015 to 2024 in Brazil. The analysis related TB cases to sex, age, year, region, schooling, homelessness, healthcare workers, alcoholism, smoking, illicit drug use, HIV, AIDS, diabetes, mental illness, and EPTB. Between 2015 and 2024, Brazil recorded 955,658 TB cases, with a 30.49% increase. The Southeast region concentrated 45.04% of cases, and the Central-West 4.85%. Men represented 70.06% of cases, with peak incidence between 20 and 29 years (24.22%); people aged 20 to 59 years accounted for 77.20% of cases. Schooling data were missing in 26% of records; 18.5% had incomplete 5th–8th grade elementary education, and the lowest prevalence (5.68%) was in incomplete or complete higher education. All risk factors increased above the overall average of 30.49%, especially smokers (117.53%), homeless populations (127.06%), and illicit drug users (130.20%). Among extrapulmonary forms, pleural (194), miliary (70), and laryngeal TB (2 cases) stood out. Findings show a marked increase in TB cases in Brazil between 2015 and 2024, with greater concentration in the Southeast and predominance among young men of working age. The analysis reinforces the role of social and behavioral determinants in worsening the scenario, highlighting the rise in cases among smokers, illicit drug users, and people experiencing homelessness. Results underscore the importance of integrated public policies to address social inequalities and improve access to TB diagnosis and treatment.