Local, regional, and continental trends in tuberculosis mortality rates across the Americas at the beginning of the XXI century.

This ecological time-series study analysed tuberculosis (TB) mortality trends in the Americas from 2000 to 2019 using data from the Pan American Health Organization. Age-adjusted mortality rates by country and sex were assessed with Joinpoint regression to estimate annual percentage changes. Results showed a general decline in TB mortality, with average annual reductions of -2.3% in men and -1.9% in women. Brazil, Colombia, and Canada exhibited continuous decreases, while Saint Lucia, Jamaica, and Honduras had episodes of increase or fluctuation. The highest mortality rates persisted in Bolivia, Mexico, Nicaragua, Honduras, and Peru. Regional analyses indicated periods of trend stabilisation, especially in Central and South America during the latter years. Despite overall progress, significant disparities by region and sex remain, reflecting complex social, economic, and healthcare factors. Strengthening surveillance systems and tailoring interventions to specific local contexts are crucial for further reducing TB mortality across the continent.