In São Paulo, resistant tuberculosis (MDR-TB) is defined for the purpose of notification and treatment, as those cases that present with in-vitro resistance to rifampicin and isoniazid, and a third standard drug. There is currently a system of epidemiological surveillance of MDR-TB, which monitors all re-treatment cases of the disease nationwide. In the State of São Paulo, this monitoring is done by the division of tuberculosis Epidemiological Surveillance Centre of São Paulo. The aim of this study was to analyse the spatial distribution of cases of resistant tuberculosis in the state of São Paulo, Brazil, in the period 2007–2010.
Methods We selected confirmed cases of MDR-TB, notified to the state of Sao Paulo in the period 1 January 2007 to 10 January 2011, with the county as the unit of spatial analysis. We also analysed data from incident cases of tuberculosis in the state during the same period and with the same spatial unit of analysis. In addition to these data, information about detention facilities was also collected. All data were analysed in GIS, using space techniques for the detection of clusters and spatial correlations.
Results We detected 355 cases of MDR-TB during the study period, 34% in 2010, 68.7% male, 63% Caucasian and 77% by 11 years of study. The mean age was 38 years (±12 years). 97% were of pulmonary disease, only 11% were HIV-positive. Using kernel parameters, the greatest probability of MDR-TB cases are concentrated in the southeastern state.
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