Temporal Analysis of Tuberculosis Mortality in Brazil Before and After the Pandemic

Objective: To assess the impact of COVID-19 pandemic on tuberculosis (TB) mortality in Brazil, comparing the pre and post-pandemic periods. Theoretical Framework: Until 2019, TB mortality had been steadily declining globally. The pandemic compromised prevention, causing stagnation/increase in mortality, especially in low and Middle income countries. Method: Ecological time series study that analyzed TB mortality rates in Brazil (2012-2022) using SIM/DATASUS and deaths classified by ICD-10 (A15 and A16). The 2022 Census population was divided into age groups: 0-19, 20-59, and ≥ 60 years. The annual mortality rate per 100,000 inhabitants per group was calculated, and trends were evaluated by segmented regression in the Joinpoint Regression Program (v. 4.5.0.1), 95% CI, and 5% significance. Results and Discussion: Among those under 19 years of age, mortality increased between 2017 and 2022 (APC=12.66%). For those aged 20-59, there was a decrease until 2020 (-1.57%/year) and a significant increase during the pandemic (+15.18%/year). The elderly saw a reduction until 2020 (-2.71%/year) and stability thereafter. Men showed a decline until 2020, followed by an increase (11.77%/year). Women had a greater reduction before 2020 (-3.01%/year), with growth in the post-pandemic period (14.16%/year). The pandemic reversed the downward trend, indicating the need for specific strategies and policy strengthening. Research Implications: It is essential to strengthen surveillance, early diagnosis, treatment, reporting, and professional training, ensuring assistance to vulnerable populations. Originality/Value: Pioneering research in Brazil that details the impact of COVID-19 on TB mortality, providing a basis for improving post-pandemic control policies and programs.