INCREASE IN CASE NUMBERS AND MOST AFFECTED SOCIAL GROUPS: AN ECOLOGICAL STUDY OF TUBERCULOSIS IN BRAZIL

Tuberculosis is a bacterial disease that leads to weight loss, night sweats, cough and fever, and can result in death. As a social disease, it requires public health attention to create policies directed at the most affected groups. To analyze trends in the number of tuberculosis cases between 2019 and 2023 in Brazil and the distribution of cases among social groups. Cross-sectional, ecological, retrospective and quantitative study using secondary data from DATASUS. Variables used were year of diagnosis, homelessness, incarceration, diabetes, alcoholism and smoking. Between 2019 and 2023, Brazil registered 487,010 cases of tuberculosis. Annual case counts were 96,685, 86,103, 91,264, 103,253 and 109,705, respectively. People experiencing homelessness accounted for 4.35% of total cases, representing 3.82% in 2019 and 5.21% in 2023. People incarcerated population accounted for 10.99% of cases (12.08% in 2019 and 10.08% in 2023). People with diabetes represented 8.62% of cases, with stable distribution. Individuals with alcoholism comprised 19.63% of cases (18.89% in 2019 and 21.02% in 2023). Smokers accounted for 25.77% of total cases (24.63% in 2019 and 28.21% in 2023). The decrease in tuberculosis cases in 2020 likely occurred due to underdiagnosis caused by the COVID-19 pandemic. The subsequent increase in disease through 2023 highlights the need for improved surveillance, early diagnosis and treatment of tuberculosis, especially in vulnerable groups. There was a proportional increase in cases among people experiencing homelessness, individuals with alcoholism and smokers, requiring greater attention for these groups. There was a proportional reduction in cases among the incarcerated population, but it is still necessary to address the unhealthy conditions and limited access to healthcare that facilitate tuberculosis transmission in prisons. People with diabetes still represent an important share of cases, although without proportional change over the years. There was an increase in tuberculosis cases, demanding attention from public health sectors to achieve effective prevention, rapid diagnosis and effective treatment. Individuals with alcoholism, smokers and people experiencing homelessness should be targeted for specific public health strategies.