Modelagem tobit em dados de área dos casos notificados por tuberculose nos municípios de Minas Gerais

Abstract

Tuberculosis (TB) is one of the most neglected notifiable diseases in the country, a significant Public Health issue, especially in Brazil, where its incidence remains a challenge. To deepen the understanding of the geographic distribution of the disease and identify areas with a higher risk of transmission, this study uses data from DATASUS (Department of Informatics of the Unified Health System), an organization of the Ministry of Health, using the TabNet tabulation tool. The analysis is conducted considering the "shape" map file from the Brazilian Institute of Geography and Statistics (IBGE) for the state of Minas Gerais. The main objective is to map areas prone to the spread of tuberculosis, exploring the socioeconomic and sociodemographic impacts. The approach adopted includes the analysis of area data, allowing the investigation of the relationship between tuberculosis incidence and geographic, socioeconomic and demographic characteristics. The Tobit and spatial Tobit (SAR-TOBIT) models are essential tools in this process, since the spatial model takes into account the spatial autocorrelation present in the data, which often presents a positive pattern. The investigation of socioeconomic variables highlighted a clear disparity, pointing out that the North and Northeast regions of Minas Gerais present less favorable conditions compared to other areas. Interestingly, Itambé de Mato Dentro was the only municipality located in quadrant 1, suggesting a possible influence on the increase in tuberculosis cases for neighbors. The spatial dependence revealed by spatial tobit is crucial for identifying areas where control strategies may not be achieving desired results. Effective implementation of this model is facilitated by the use of R software. Various measures can be recommended to address tuberculosis, this includes improving access to health services for proper diagnosis and treatment, educational campaigns to increase awareness, screening programs and mass testing, ensuring adequate treatment and follow-up for diagnosed patients, as well as efforts to address social determinants of health. In this way, this research contributes substantially to the monitoring and control of tuberculosis in the State of Minas Gerais.