Mortalidade por tuberculose pediátrica no Brasil, 1996–2024: tendência temporal e crescimento na Região Norte

Abstract

Introduction:  Tuberculosis (TB) is a leading infectious cause of death worldwide, and pediatric TB in Brazil remains understudied despite the targets of the National Plan to End Tuberculosis.

Objective:  To analyze the temporal trend of respiratory TB mortality (ICD-10: A15–A16) in children and adolescents aged 0–14 years in Brazil, from 1996 to 2024, by macroregion.

Method:  Ecological time-series study using data from the Mortality Information System (SIM/DATASUS). Log-linear regression with autocorrelation-corrected standard errors (HAC-SE, Newey-West, lag 1) was used to estimate the annual percent change (APC) and 95% confidence intervals for the complete series (1996–2024), the early phase (1996–2007), and the recent period (2010–2024).

Results:  A total of 972 deaths were recorded (mean: 33.5/year; SD: 14.2). Brazil showed a significant decline in the complete series (APC = −3.41%/year; 95%CI: −4.88 to −1.92; p < 0.001) and in the early phase (APC = −6.82%/year; p < 0.001); in 2010–2024, the national trend was not significant (APC = +2.00%; p = 0.173). The Northern region was the only macroregion with significant growth in the recent series (+5.18%/year; 95%CI: +1.52 to +8.97; p = 0.009), with a 72% increase in the annual mean number of deaths in 2020–2024 versus 2010–2019.

Conclusion:  Brazil achieved an expressive decline in pediatric TB mortality until 2007, followed by stagnation. The significant growth in the Northern region represents an epidemiological setback incompatible with the targets of the National Tuberculosis Elimination Plan, requiring urgent strengthening of surveillance and of access to pediatric diagnosis and treatment within the SUS