Tuberculosis dynamics from spatial analysis: integrative review Dinâmica da tuberculose a partir de análise espacial: revisão integrativa Dinámica de la tuberculosis a partir del análisis espacial: revisión integradora

Objective: to analyze from literature, the contributions of spatial analysis to comprehend the tuberculosis dynamics. Method: integrative review of literature preformed within 2008 to 2017, developed from published manuscripts in any language on LILACS, PubMed and SCOPUS databases. Results: 140 studies were retrieved, of which 50 were included. The main findings refer to predominance of the use of tuberculosis incidence rates as outcome variable and its association with social and geographic conditions. The American continent presented the highest number of studies, although the African countries presented the highest incidence rates. Conclusion: the complexity of tuberculosis incidence in the geographic space is associated with epidemiologic factors. The spatial analysis presents advancements for the management of tuberculosis worldwide allowing identifying inequalities and health conditions of a population. Descriptors: Tuberculosis; Spatial Analysis; Epidemiology; Review. RESUMO Objetivo: analisar a partir da literatura, as contribuições da análise espacial para compreender a dinâmica da tuberculose. Método: revisão integrativa da literatura realizada no período de 2008 a 2017, desenvolvida a partir de manuscritos publicados em qualquer idioma nas bases de dados LILACS, PubMed e SCOPUS. Resultados: foram resgatados 140 estudos, dos quais 50 incluídos. Os principais achados referem-se à predominância do uso das taxas de incidência de tuberculose como variável de desfecho e sua associação com as condições sociais e geográficas. O continente americano apresentou o maior número de estudos, apesar dos países africanos apresentarem as maiores taxas de incidência. Conclusão: a complexidade da incidência da tuberculose no espaço geográfico está associada aos fatores epidemiológicos. A análise espacial representa avanços para o gerenciamento da tuberculose mundialmente permitindo identificar desigualdades e condições de saúde de uma população. Descritores: Tuberculose; Análise Espacial; Epidemiologia; Revisão. RESUMÉN Objetivo: Analizar a partir de la literatura las contribuciones del análisis espacial para comprender la dinámica de la tuberculosis. Método: revisión bibliográfica integradora realizada entre 2008 y 2017, desarrollada a partir de manuscritos publicados en cualquier idioma en las bases de datos LILACS, PubMed y SCOPUS. Resultados: se rescataron 140 estudios, de los cuales se incluyeron 50. Los principales hallazgos se refieren al predominio del uso de tasas de incidencia de tuberculosis como variable de resultado y su asociación con condiciones sociales y geográficas. El continente americano presentó el mayor número de estudios, aunque los países africanos tuvieron las tasas de incidencia más altas. Conclusión: La complejidad de la incidencia de tuberculosis en el espacio geográfico está asociada a factores epidemiológicos. El análisis espacial representa los avances en el manejo de la tuberculosis en todo el mundo, lo que permite identificar las desigualdades y las condiciones de salud de una población. Descriptores: Tuberculosis; Análisis Espacial; Epidemiología; Revisión. How to cite: Lima SVMA, dos Santos MD, Silva LD, Nascimento JC, dos Santos AD, de Oliveira ET, et al. Tuberculosis dynamics from spatial analysis: integrative review. Rev Pre Infec e Saúde [Internet]. 2019;5:9194. Available from: http://www.ojs. ufpi.br/index.php/nupcis/article/view/9194 DOI: https://doi.org/10.26694/repis.v5i0. 8822 Lima SVMA, et al. Tuberculosis dynamics from spatial analysis Rev Pre Infec e Saúde. 2019;5:9194 2 INTRODUCTION Tuberculosis (TB) is a disease caused by a slow growth bacillus, Mycobacterium tuberculosis, strict aerobic, acid-alcohol resistant (BAAR), of aerogenous transmissibility, that mainly affects lungs. It is closely related to poverty, poor living and housing conditions and human agglomeration. Although government implementation of various control and vigilance strategies, TB persists as a big public health problem. It is estimated that one third of world population is infected by Koch bacillus. The African and Asian regions are the ones that present most risk of illness. Six countries were responsible for 60% of new worldwide TB cases in 2015: India, Indonesia, China, Nigeria, Pakistan and South Africa. The global progress to fight the disease depends on advancements in patient prevention and care in all the countries with high TB load, among them Brazil. The TB issue reflects the social development stage of the country, in which poverty determinants, poor sanitary conditions, significative increase of acquired immune deficiency syndrome (AIDS) cases, populational growth, large migratory movements and lack of management organization and health services limit the measures for eradication of the disease, keeping it endemic mainly in the most vulnerable populations, justifying the persistence of TB as serious public health problem. Developing countries, such as Brazil, are those that present the highest incidence rates of the disease because they share some common characteristics in high-risk global regions, as the high urbanization index, high social inequality and ethnic and cultural diversity as well as the neglected control by public policies and society, making it difficult to comprehend the disease dynamics and responsiveness. In the last decades, the development of new statistical techniques deployed to epidemiology as well as the use of computers and creation of new programs have helped in a better comprehension of the health-disease process, making the application of analyses from data obtained in epidemiologic investigations accessible to an increasing number of researchers by extracting elements that contribute to minimize the health problems of society. Also, elements for the orientation of intersectoral actions that contribute to decision making have been provided. In this sense, the use of technologies that can subsidize the decision making, organizing and planning actions to eradicate TB is substantial. The geographic information systems associated with geoprocessing techniques constitute a big tool for TB monitoring, control and evaluation, as they lead to distribution dynamics understanding between illness and death risks because it allows an evaluation of TB distribution and its populational determinants in space and time. Therefore, it was chosen as objective to analyze from the literature the contributions of spatial analysis for comprehending TB dynamics.