Tropical medicine and infectious disease · 2025
Spatial Analysis of Drug-Resistant Tuberculosis in Colombia (2020-2023): Departmental Rates, Clusters, and Associated Factors.
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Patiño-Palma Brayan, Chacon-Bambague Sandra, Bermudez-Moreno Farlhyn, Peña-Briceño Carmencita, Bustos-Carvajal Juan, Arias-Coronel Florencio
Аннотация
BACKGROUND: Drug-resistant tuberculosis (DR-TB) constitutes a serious threat to global public health due to the increase in strains resistant to multiple drugs, especially isoniazid and rifampicin. This resistance increases mortality, estimated at 25.6% globally, and complicates treatments due to its high toxicity and cost.
MATERIALS AND METHODS: A quantitative ecological study was carried out with data on drug-resistant tuberculosis reported in Sivigila in the years (2020-2023) SIVIGILA database. 1694 cases were analyzed, considering sociodemographic variables such as age, sex, nationality and prioritized population groups. Departmental rates per 100,000 inhabitants were calculated with DANE projection, from these choropleth maps were developed. Applying a Kulldorff spatial scan under a Poisson model using the SMERC package of R (version 4.5.1), with windows centered on each department and Monte Carlo simulation contrast to identify high-risk clusters (RR > 1).
RESULTS: (DR-TB) Predominantly in men aged 30-44 years, with a progressive increase until 2023 (IRR = 2.11). Three high-risk clusters were detected in the southwest and center of the country.
DISCUSSION: Drug-resistant tuberculosis in Colombia showed a sustained increase in the years of study, with a cumulative increase of 110% compared to 2020, associated with economically active people more exposed due to occupational and social factors. The greatest burden was observed in the general population. Cases also increased in groups with social and health vulnerability conditions.
CONCLUSIONS: The departments of Risaralda, Meta, and Valle del Cauca presented the highest drug resistance rates in Colombia.
MATERIALS AND METHODS: A quantitative ecological study was carried out with data on drug-resistant tuberculosis reported in Sivigila in the years (2020-2023) SIVIGILA database. 1694 cases were analyzed, considering sociodemographic variables such as age, sex, nationality and prioritized population groups. Departmental rates per 100,000 inhabitants were calculated with DANE projection, from these choropleth maps were developed. Applying a Kulldorff spatial scan under a Poisson model using the SMERC package of R (version 4.5.1), with windows centered on each department and Monte Carlo simulation contrast to identify high-risk clusters (RR > 1).
RESULTS: (DR-TB) Predominantly in men aged 30-44 years, with a progressive increase until 2023 (IRR = 2.11). Three high-risk clusters were detected in the southwest and center of the country.
DISCUSSION: Drug-resistant tuberculosis in Colombia showed a sustained increase in the years of study, with a cumulative increase of 110% compared to 2020, associated with economically active people more exposed due to occupational and social factors. The greatest burden was observed in the general population. Cases also increased in groups with social and health vulnerability conditions.
CONCLUSIONS: The departments of Risaralda, Meta, and Valle del Cauca presented the highest drug resistance rates in Colombia.