Authors
Ruitong Wang, Geziel Dos Santos de Sousa, Antonio Silva Lima Neto, Marcia C Castro
Published in
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. Pages 109134. Sep 20, 2026. Epub Sep 20, 2026.
Abstract
Violence may be associated with tuberculosis (TB) burden through multiple pathways. We examined associations between homicide rates (a proxy for neighborhood violence) and TB-related outcomes in 114 bairros in Fortaleza, Brazil, from 2014 to 2023.
We analyzed homicide rates, incidence of newly reported TB, and rates of TB with unsuccessful treatment outcomes. We assessed spatial autocorrelation and clusters using Moran's I and space-time scan statistics. Geographically weighted regression (GWR) and Bayesian spatial models assessed spatial and spatiotemporal associations.
Annual homicide rates ranged from 26.8-81.1 per 100,000. Newly reported TB incidence was 50-60 per 100,000 during 2015-2021 and 66.8 in 2023, while rate of TB with unsuccessful outcomes increased from 10.8 to 17.5. GWR models showed positive associations between cumulative homicide rates and cumulative incidence of newly reported TB (β>0.5, p<0.05) and rates of TB with unsuccessful outcomes (0<β<0.5, p<0.05) across all bairros. Bayesian models showed associations per one-SD increase in homicide rate with newly reported TB (RR=1.05, 95% CrI:1.02-1.08) and TB with unsuccessful outcomes (RR=1.11, 95% CrI:1.05-1.18).
Higher homicide rates were spatially and spatiotemporally associated with higher TB burden. Violence may serve as an indicator of neighborhoods with elevated TB burden.
PMID:
42764040
Bibliographic data and abstract were imported from PubMed on 21 Sep 2026.
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