TUBERCULOSIS TRENDS IN MARANHÃO (2016-2024): ANALYSIS OF THE IMPACT OF THE COVID-19 PANDEMIC AND POST-PANDEMIC CHALLENGES

Abstract

Tuberculosis (TB) remains a serious public health problem in Brazil, particularly in states like Maranhão, which presents spatial heterogeneity and socioeconomic challenges. The COVID-19 pandemic significantly impacted health services, raising concerns about its effects on TB control. This study aimed to analyze the trend of notified tuberculosis cases in the state of Maranhão between 2016 and 2024, focusing on the impacts of the pandemic and subsequent recovery. This is a descriptive and analytical epidemiological time-series study, using aggregated secondary data of annual TB notifications (likely from the Notifiable Diseases Information System - SINAN). The analyzed data cover the period from 2016 to 2024. Descriptive statistical analysis was performed, including calculation of means, standard deviations, and percentage variations annually and between periods (pre-pandemic: 2016-2019; pandemic: 2020-2021; post-pandemic: 2022-2024). An average of 2559.00 cases/year was observed in the pre-pandemic period, rising to 2686.00 (+4.96%) during the pandemic and reaching 3343.33 (+24.47% compared to the pandemic period; +30.65% compared to the pre-pandemic period) post-pandemic. The drop in 2020 (-7.09%) was followed by significant annual increases, culminating in 3452 cases in 2024. The discussion addresses how the disruption of services during the pandemic affected notification, contextualizing with findings on the clinical-epidemiological, spatial, and social profile of TB in the state and other regions, and how the post-pandemic increase reflects recovery and backlogged cases. It is concluded that the pandemic caused significant disruption, followed by a marked increase in notifications. Continuous strengthening of surveillance, active case finding, reinforcement of Primary Health Care, addressing social determinants, and health education actions are recommended, paying attention to regional particularities and vulnerable groups.