598 Silicose’s impact on the incidence of tuberculosis in the general population of minas gerais: analysis from 2002 to 2016


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Abstract

IntroductionIn Brazil, both silicosis and tuberculosis (TB) have high prevalence rates, although there are regional differences. Silicosis is the most common pneumoconiosis in the world and silica´s exposure is a predisposing factor for TB, even in workers without silicosis. However, little is known about the influence of silicosis on TB rates in general population. The objective of this study is evaluate the impact of silicosis on epidemiology of tuberculosis in general population in cities of Minas Gerais (MG) state.MethodsEcological study, based on DATASUS data, from 2002 to 2016. TB rates in cities with known silica exposure (case-cities) were compared to others with no evidence of such exposure (control cities). The cities were matched in relation to: incidence of AIDS, HDI (longevity, education and income) and percentage of occupation in the mineral´s extractivism sector.ResultThe TB rates per 1 00 000 inhabitants were higher in the case-cities compared to the control-cities (158,8 and 41,3, respectively, p=0.00032). In the case-cities, the ratio found of man and women with TB was 1.85/1, being close to the rest of the state (2.29/1 in 2015).DiscussionThe silica exposure and silicosis may influence the elevation of TB rates in the general MG population. Because of the similarity of male/female ratio in the case-cities when compared to the rest of the state, it’s possible that this increase does not come only from patients with silico-tuberculosis. The difficulties of diagnosis and treatment of TB in patients with silicosis delay the therapeutic strategy, which may result in a greater spread of TB among their contacts. However, new studies are needed to determine risk factors at the individual level, in order to guide preventive actions for silicosis and TB in regions with silica exposure activities.

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