Tuberculosis forecasting and temporal trends by sex and age in a high endemic city in northeastern Brazil: where were we before the Covid-19 pandemic?

Hamilton Leandro Pinto de Andrade, Dulce Gomes, Antônio Carlos Vieira Ramos, Luiz Henrique Arroyo, Marcelino Santos-Neto, Pedro Fredemir Palha, Regina Célia Fiorati, Inês Fronteira, Aline Aparecida Monroe, Márcio Souza dos Santos, Miguel Fuentealba-Torres, Mellina Yamamura, Juliane de Almeida Crispim, Ricardo Alexandre Arcêncio*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: The aim of this study was to describe the temporal trend of tuberculosis cases according to sex and age group and evidence the level of disease before the Covid-19 pandemic in a TB high endemic city. Methods: This was a time series study carried out in a city in northeast Brazil. The population was composed of cases of tuberculosis, excluding those with HIV-positive status, reported between the years 2002 and 2018. An exploratory analysis of the monthly rates of tuberculosis detection, smoothed according to sex and age group, was performed. Subsequently, the progression of the trend and prediction of the disease were also characterized according to these aspects. For the trends forecast, the seasonal autoregressive linear integrated moving average (ARIMA) model and the usual Box-Jenkins method were used to choose the most appropriate models. Results: A total of 1620 cases of tuberculosis were reported, with an incidence of 49.7 cases per 100,000 inhabitants in men and 34.0 per 100,000 in women. Regarding the incidence for both sexes, there was a decreasing trend, which was similar for age. Evidence resulting from the application of the time series shows a decreasing trend in the years 2002–2018, with a trend of stability. Conclusions: The study evidenced a decreasing trend in tuberculosis, even before the Covid-19 pandemic, for both sex and age; however, in a step really slow from that recommended by the World Health Organization. According to the results, the disease would have achieved a level of stability in the city next years, however it might have been aggravated by the pandemic. These findings are relevant to evidence the serious behavior and trends of TB in a high endemic scenario considering a context prior to the Covid-19 pandemic.

Original languageEnglish
Article number1260
Pages (from-to)1260
JournalBMC Infectious Diseases
Issue number1
StatePublished - 18 Dec 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).


  • Covid-19
  • Ecological studies
  • Epidemiology
  • Nursing
  • Time series studies
  • Tuberculosis


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