Jaqueline Garcia de Almeida Ballestero, José Nildo de Barros Silva Júnior, Luiz Henrique Arroyo, Daniele Maria Pelissari, Isabela Zaccaro Rigolin, Pedro Fredemir Palha, Aline Aparecida Monroe, Quézia Rosa Ferreira, Gilberto da Cruz Leal, Leonora de Oliveira Teixeira, Yury Bitencourt da Costa, Ione Carvalho Pinto, Rubia Laine de Paula Andrade, Ricardo Alexandre Arcêncio
{"title":"耐药结核病的空间风险集群和护理制图。","authors":"Jaqueline Garcia de Almeida Ballestero, José Nildo de Barros Silva Júnior, Luiz Henrique Arroyo, Daniele Maria Pelissari, Isabela Zaccaro Rigolin, Pedro Fredemir Palha, Aline Aparecida Monroe, Quézia Rosa Ferreira, Gilberto da Cruz Leal, Leonora de Oliveira Teixeira, Yury Bitencourt da Costa, Ione Carvalho Pinto, Rubia Laine de Paula Andrade, Ricardo Alexandre Arcêncio","doi":"10.11606/s1518-8787.2025059006489","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To identify spatial clusters of risk and map the care network for people with drug-resistant tuberculosis in the state of São Paulo.</p><p><strong>Methods: </strong>This is an ecological study, carried out by collecting data from the Special Tuberculosis Treatment Information System (Site-TB) of people treated for drug-resistant tuberculosis from 2013 to 2020, in the state of São Paulo. Mapping was carried out using Kernel and scan statistic techniques.</p><p><strong>Results: </strong>1,084 cases were reported in the period analyzed. São Paulo, Ribeirão Preto, Santos, Guarulhos, and Campinas were the municipalities with the highest number of cases. The spatial pattern of agglomeration of cases and referral centers for treatment were similar, with gaps in coverage in the southwest and northwest of the state. Six spatial clusters were identified: four low-risk and two high-risk, located in São Paulo, Diadema, Santos, and Guarujá.</p><p><strong>Conclusions: </strong>The concentration of cases and tertiary referral centers in metropolitan areas highlights inequalities in access to treatment for drug-resistant tuberculosis. These findings indicate the need for health policies to expand diagnosis and treatment, improving the control of drug-resistant tuberculosis in the state of São Paulo.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"59 ","pages":"e11"},"PeriodicalIF":2.1000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211794/pdf/","citationCount":"0","resultStr":"{\"title\":\"Spatial clusters of risk and cartography of care for drug-resistant tuberculosis.\",\"authors\":\"Jaqueline Garcia de Almeida Ballestero, José Nildo de Barros Silva Júnior, Luiz Henrique Arroyo, Daniele Maria Pelissari, Isabela Zaccaro Rigolin, Pedro Fredemir Palha, Aline Aparecida Monroe, Quézia Rosa Ferreira, Gilberto da Cruz Leal, Leonora de Oliveira Teixeira, Yury Bitencourt da Costa, Ione Carvalho Pinto, Rubia Laine de Paula Andrade, Ricardo Alexandre Arcêncio\",\"doi\":\"10.11606/s1518-8787.2025059006489\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To identify spatial clusters of risk and map the care network for people with drug-resistant tuberculosis in the state of São Paulo.</p><p><strong>Methods: </strong>This is an ecological study, carried out by collecting data from the Special Tuberculosis Treatment Information System (Site-TB) of people treated for drug-resistant tuberculosis from 2013 to 2020, in the state of São Paulo. Mapping was carried out using Kernel and scan statistic techniques.</p><p><strong>Results: </strong>1,084 cases were reported in the period analyzed. São Paulo, Ribeirão Preto, Santos, Guarulhos, and Campinas were the municipalities with the highest number of cases. The spatial pattern of agglomeration of cases and referral centers for treatment were similar, with gaps in coverage in the southwest and northwest of the state. Six spatial clusters were identified: four low-risk and two high-risk, located in São Paulo, Diadema, Santos, and Guarujá.</p><p><strong>Conclusions: </strong>The concentration of cases and tertiary referral centers in metropolitan areas highlights inequalities in access to treatment for drug-resistant tuberculosis. These findings indicate the need for health policies to expand diagnosis and treatment, improving the control of drug-resistant tuberculosis in the state of São Paulo.</p>\",\"PeriodicalId\":21230,\"journal\":{\"name\":\"Revista de saude publica\",\"volume\":\"59 \",\"pages\":\"e11\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-06-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211794/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista de saude publica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.11606/s1518-8787.2025059006489\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista de saude publica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.11606/s1518-8787.2025059006489","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Spatial clusters of risk and cartography of care for drug-resistant tuberculosis.
Objective: To identify spatial clusters of risk and map the care network for people with drug-resistant tuberculosis in the state of São Paulo.
Methods: This is an ecological study, carried out by collecting data from the Special Tuberculosis Treatment Information System (Site-TB) of people treated for drug-resistant tuberculosis from 2013 to 2020, in the state of São Paulo. Mapping was carried out using Kernel and scan statistic techniques.
Results: 1,084 cases were reported in the period analyzed. São Paulo, Ribeirão Preto, Santos, Guarulhos, and Campinas were the municipalities with the highest number of cases. The spatial pattern of agglomeration of cases and referral centers for treatment were similar, with gaps in coverage in the southwest and northwest of the state. Six spatial clusters were identified: four low-risk and two high-risk, located in São Paulo, Diadema, Santos, and Guarujá.
Conclusions: The concentration of cases and tertiary referral centers in metropolitan areas highlights inequalities in access to treatment for drug-resistant tuberculosis. These findings indicate the need for health policies to expand diagnosis and treatment, improving the control of drug-resistant tuberculosis in the state of São Paulo.
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