Dinâmica Espaço-Temporal da Coinfecção TB-HIV em Regiões de Saúde da Amazônia Brasileira

Graziele Padilha Macedo; Jeandson Mateus Ribeiro Coelho; Maiara Hildegard Maia Amaral; Maria Alice da Silva Santos; Diego Simeone

doi:10.36489/saudecoletiva.2026v18i111p20540-20553

Authors

Graziele Padilha Macedo Acadêmica de medicina na Afya Faculdade de Ciências Médicas, Bragança, Pará, Brasil. https://orcid.org/0009-0009-3242-3861
Jeandson Mateus Ribeiro Coelho Acadêmico de medicina na Afya Faculdade de Ciências Médicas, Bragança, Pará, Brasil. https://orcid.org/0009-0001-1662-4569
Maiara Hildegard Maia Amaral Acadêmica de medicina na Afya Faculdade de Ciências Médicas, Bragança, Pará, Brasil https://orcid.org/0009-0001-6016-7924
Maria Alice da Silva Santos Acadêmica de medicina na Afya Faculdade de Ciências Médicas, Bragança, Pará, Brasil. https://orcid.org/0009-0002-2266-2219
Diego Simeone Doutor, Professor na Afya Faculdade de Ciências Médicas, Bragança, Pará, Brasil. https://orcid.org/0000-0003-0190-6659

DOI:

https://doi.org/10.36489/saudecoletiva.2026v18i111p20540-20553

Keywords:

Tuberculosis, HIV, Spatial Analysis

Abstract

Tuberculosis-HIV (TB-HIV) coinfection remains a major public health problem in the Brazilian Amazon, particularly in areas marked by socioeconomic vulnerability and limited access to healthcare services. This retrospective ecological study analyzed reported cases between 2010 and 2024 aggregated by health regions. Annual incidence rates were calculated per 100,000 inhabitants, while temporal trends were assessed using negative binomial regression and generalized least squares models. Spatial analysis included Global Moran’s Index, local spatial autocorrelation, and spatial autoregressive modeling. A progressive increase in incidence was observed throughout the study period, with intensification after 2018, reduction in 2020, and subsequent recovery. Spatial analysis revealed significant autocorrelation, with higher-risk clusters concentrated in the western and central Amazon and lower-risk areas in the eastern portion. These findings demonstrate sustained growth and heterogeneous distribution of TB-HIV coinfection, highlighting the need for integrated surveillance and control strategies in priority regions.

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