Tuberculosis among People Living on the Street and Using Alcohol, Tobacco, and Illegal Drugs: Analysis of Territories in Extreme Vulnerability and Trends in Southern Brazil

Alessandro Rolim Scholze, Josilene Dália Alves, Thaís Zamboni Berra, Antônio Carlos Vieira Ramos, Flávia Meneguetti Pieri, Sandra Cristina Pillon, Júlia Trevisan Martins, Maria José Quina Galdino, Emiliana Cristina Melo, Felipe Mendes Delpino, Ariela Fehr Tártaro, Inês Fronteira and Ricardo Alexandre Arcêncio
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Alessandro Rolim Scholze: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Josilene Dália Alves: Institute of Biological Sciences and Health, Federal University of Mato Grosso, Barra do Garças 78605-091, Brazil
Thaís Zamboni Berra: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Antônio Carlos Vieira Ramos: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Flávia Meneguetti Pieri: Department of Nursing, State University of Londrina, Londrina 86057-970, Brazil
Sandra Cristina Pillon: Department of Psychiatric Nursing and Human Sciences, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Júlia Trevisan Martins: Department of Nursing, State University of Londrina, Londrina 86057-970, Brazil
Maria José Quina Galdino: Department of Nursing, State University of Northern Paraná, Bandeirantes 86360-000, Brazil
Emiliana Cristina Melo: Department of Nursing, State University of Northern Paraná, Bandeirantes 86360-000, Brazil
Felipe Mendes Delpino: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Ariela Fehr Tártaro: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil
Inês Fronteira: Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, University Nova de Lisboa, 1349-008 Lisboa, Portugal
Ricardo Alexandre Arcêncio: Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil

IJERPH, 2022, vol. 19, issue 13, 1-14

Abstract: (1) Background: Tuberculosis presents an epidemiological trend toward inequality, especially among people in social exclusion and situations of vulnerability. This study aimed to analyze territories with a concentration of people diagnosed with tuberculosis in a street situation and who partake in chronic use of alcohol, tobacco, and illicit drugs. We also analyzed trends in this health condition in southern Brazil. (2) Methods: Ecological study, developed in the 399 municipalities of Paraná, southern Brazil, with all tuberculosis cases in the homeless population registered in the Information System of Notifiable Diseases between 2014 and 2018. For data analysis, we used descriptive statistics, the Prais–Winsten autoregression method for the time series, and the Getis-Ord Gi technique* for spatial analysis. (3) Results: in total, 560 cases were reported. We found a predominance of alcohol, smoking, and illicit drug users, with an increasing trend in the state and clusters of spatial risk in the East health macro-region. (4) Conclusions: We observed territories with critical levels of highly vulnerable people who use psychoactive substances and are in a street situation. The results highlight the importance of incorporating public policies of social protection for these individuals and resolutive health services that receive these cases and assist in eradicating TB.

Keywords: tuberculosis; vulnerable populations; homeless persons; substance-related disorders (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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