Influence of primary care coverage and home visits on the detection of tuberculosis cases in the municipality of Rio de Janeiro, Brazil, 2014-2022

Abstract

Despite efforts to reduce its incidence, tuberculosis (TB) control still challenges the municipality of Rio de Janeiro, Brazil. This study aimed to analyze the temporal trend and effect of TB surveillance and access to health services on the detection of TB cases in Rio de Janeiro (2014-2022). This ecological study evaluated all cases of TB that were reported monthly in residents of Rio de Janeiro. A segmented joinpoint regression model was developed to identify points of change in the trend of notifications and calculate monthly percentage changes. Generalized additive models were used to evaluate the effect of implementing the rapid molecular test, TB surveillance actions, and primary care coverage in the detection of TB cases. The period from January 2014 to December 2022 showed a median of 677 cases of TB per month, with an increasing monthly variation of 0.49% (95%CI: 0.19; 0.79) from January 2014 to August 2017 and of 0.72% (95%CI: 0.16; 1.29) from December 2020 to December 2022. The multiple models associated the number of home visits and percentage of primary care coverage with the notification of TB cases. Access to primary care services and the increase in home visits are essential to expand the detection of TB cases in Rio de Janeiro by the rapid molecular test.