title: Temporal distribution of tuberculosis in the State of Amazonas, Brazil.
abstract: Tuberculosis (TB) is one of the infectious diseases that contributes most to the morbidity and mortality of millions of people worldwide. Brazil is one of 22 countries that accounts for 80% of the tuberculosis global burden. The highest incidence rates in Brazil occur in the States of Amazonas and Rio de Janeiro. The aim of this study was to describe the temporal distribution of TB in the State of Amazonas. Between 2001 and 2011, 28,198 cases of tuberculosis were reported in Amazonas, distributed among 62 municipalities, with the capital Manaus reporting the highest (68.7%) concentration of cases. Tuberculosis was more prevalent among males (59.3%) aged 15 to 34 years old (45.5%), whose race/color was predominantly pardo (64.7%) and who had pulmonary TB (84.3%). During this period, 81 cases of multidrug-resistant TB were registered, of which the highest concentration was reported from 2008 onward (p = 0.002). The municipalities with the largest numbers of indigenous individuals affected were São Gabriel da Cachoeira (93%), Itamarati (78.1%), and Santa Isabel do Rio Negro (70.1%). The future outlook for this region includes strengthening the TB control at the primary care level, by expanding diagnostic capabilities, access to treatment, research projects developed in collaboration with the Dr. Heitor Vieira Dourado Tropical Medicine Foundation .;Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD).; and financing institutions, such as the project for the expansion of the Clinical Research Center and the creation of a hospital ward for individuals with transmissible respiratory diseases, including TB.
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Marlucia da Silva
authors.initials: Mda S
authors.lastname: Garrido
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Samira
authors.initials: S
authors.lastname: Bührer-Sékula
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Alexandra Brito de
authors.initials: AB
authors.lastname: Souza
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Rajendranath
authors.initials: R
authors.lastname: Ramasawmy
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Patrícia de Lima
authors.initials: Pde L
authors.lastname: Quincó
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Rossicleia Lins
authors.initials: RL
authors.lastname: Monte
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Lucilaide Oliveira
authors.initials: LO
authors.lastname: Santos
authors.affiliation: Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, AM, Brazil.
authors.forename: Tomás Maria
authors.initials: TM
authors.lastname: Perez-Porcuna
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Flor Ernestina
authors.initials: FE
authors.lastname: Martinez-Espínosa
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Valéria
authors.initials: V
authors.lastname: Saraceni
authors.affiliation: Departamento de Ensino e Pós-Graduação, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cordeiro-Santos
mesh_terms: D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D018563:Disease Notification; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D017678:Sex Distribution; D014376:Tuberculosis / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology