Tuberculosis in the Marianao Municipality: Trends in Two Recent Periods, 2001-2005 and 2015-2020/ La tuberculosis en el municipio Marianao: tendencias en dos periodos recientes, 2001–2005 y 2015–2020

Abstract

Introduction: Marianao has historically been a municipality of Havana with a high burden of tuberculosis. A new look would be important. Objective: To assess the TB situation of health areas with their internal territorial inequalities in 2001-2005 and 2015-2020. Methods: Ecological study of time series of TB notification rates in the health areas in Marianao municipality. The source was the surveillance data base of Municipal Hygiene and Epidemiology Center. The variables were: number of cases, notification rates and years. The geometric mean of rates was calculated, we take the lowest as reference to estimate the absolute and relative differences and the population attributable risk percentage. The total and average annual variations, the Pearcy Keppel Indices and the variance between groups were calculated. The concentration points of cases in the neighborhoods in 2015-2020 were mapped and their proportions were calculated. Results: In both periods, the November 27 health area contributed the highest geometric mean, 10.7 and 18.3; respectively. Relative inequality fluctuated between 5 and 2 times more than the reference. The largest reduction occurred in 2015-2020 (60.1 %). The dispersion indices showed moderate inequalities at both times. 58.5 % of the 94 cases in 2015-2020 were concentrated in 6/30 neighborhoods. Conclusions: In the health areas of the Marianao municipality, inequalities in both periods were moderate; it would be beneficial to execute differentiated interventions in their vulnerable neighborhoods to achieve the path of elimination of TB as a public health problem.

Keywords

• health areas
• territorial inequalities
• elimination
• tuberculosis