Spatial pattern and temporal trend of mortality due to tuberculosis.
Ana Angélica Rêgo de Queiroz, Thaís Zamboni Berra, Maria Concebida da Cunha Garcia and 6 others
PMID 29742272WHAT IT FOUND
TB mortality in Natal, Brazil, remained stable from 2008 to 2014 despite a slight downward trend.
Deaths were concentrated in specific neighborhoods within the Eastern health district, highlighting areas where nursing care and surveillance resources are most needed.
Key findings
01The annual variation in TB mortality rates was -2.2% (95%CI -4.8%; -0.3%), indicating a stable trend rather than a significant decline during the study period.
02After statistical correction for small population instability, the neighborhood with the highest rate of TB deaths as an underlying cause was Praia do Meio, located in the Eastern health district.
03Most deaths occurred in hospitals among patients who had received medical care prior to death, suggesting that primary healthcare services may have failed to provide early diagnosis or effective management.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relied on secondary data from death certificates, which are subject to underreporting and incomplete fields, potentially biasing the results. Data collection occurred in March 2015, so the total number of TB deaths up to 2014 might not have been fully updated, affecting the accuracy of the temporal series analysis. The study did not adjust for all socioeconomic variables, so the association between poverty and TB mortality is descriptive rather than causal.
Declared interests
The study was supported by the São Paulo Research Foundation. No other conflicts of interest were declared.
The easy way to misread this
Do not interpret the -2.2% annual variation as a successful reduction in TB mortality. The confidence interval includes zero, and the authors explicitly state the rate remained stable, meaning the 'End TB' targets for significant reduction were not met in this area during the study period.