TUBERCULOSIS IN THE STATE OF SÃO PAULO: CONCERN REGARDING SMALL MUNICIPALITIES

Although tuberculosis is a treatable and curable disease, it continues to be considered a public health problem. This is partly due to delays in disease confirmation by health professionals and the psychological impacts of the disease, which hinder care-seeking behavior and negatively affect treatment. In Brazil, tuberculosis presents heterogeneous scenarios, with regions that have greater health infrastructure compared to others with fewer resources, placing populations in vulnerable situations. To evaluate the epidemiological profile of tuberculosis in municipalities of the state of São Paulo. Historical ecological cohort study based on secondary data obtained from DATASUS/SINAN on tuberculosis diagnoses in 2024. Population data for each municipality were extracted from SIDRA (IBGE Automatic Recovery System) for 2022. A total of 24,225 tuberculosis cases were recorded in the state of São Paulo, representing an average incidence rate of 0.05%. The proportion of tuberculosis cases was higher among Black and Mixed-race individuals (53%) compared to White individuals (35%), similar to mortality proportions (54% and 36.9%, respectively). The highest incidence rates were detected in small municipalities with fewer than 10,000 inhabitants, such as Balbinos (31 cases; population 3,887; 0.79%), Florínea (21 cases; population 3,851; 0.54%), Lavínia (51 cases; population 9,689; 0.52%), Pracinha (11 cases; population 2,578; 0.42%), and Álvaro Carvalho (18 cases; population 4,808; 0.37%). Black and Mixed-race populations require greater incentives for health promotion related to prevention and treatment, given the higher incidence and mortality. Additionally, small municipalities require health policies focused on TB detection and screening and demand special attention to infrastructure and primary healthcare.