Evidence map›Paper›PMID 40298687›Full record

ArticleRevista de saude publica2025

BCG vaccination decline and pediatric tuberculosis rise in Brazil: spatial-temporal study.

Fabiana Rabe Carvalho, Alice Ramos-Silva, Debora Castanheira Pires, Carla Veras Yigashira Oliveira, Claudete Aparecida Araújo Cardoso, Clemax Couto Sant'Anna, Elisangela Costa Lima, Andrea Alice Silva

Abstract read
In one paragraph

Article in Revista de saude publica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Fabiana Rabe CarvalhoUniversidade Federal Fluminense. Faculdade de Medicina. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas. Niterói, RJ, Brasil.ORCID http://orcid.org/0000-0002-4713-233X
Alice Ramos-SilvaUniversidade Federal Fluminense. Faculdade de Medicina. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas. Niterói, RJ, Brasil.ORCID http://orcid.org/0000-0001-6037-8206
Debora Castanheira PiresInstituto Nacional de Infectologia Evandro Chagas. Laboratório de pesquisas clínicas em IST e Aids. Rio de Janeiro, RJ, Brasil.ORCID http://orcid.org/0000-0001-6995-1259
Carla Veras Yigashira OliveiraUniversidade Federal Fluminense. Faculdade de Medicina. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas. Niterói, RJ, Brasil.ORCID http://orcid.org/0009-0004-4625-9541
Claudete Aparecida Araújo CardosoUniversidade Federal Fluminense. Faculdade de Medicina. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas. Niterói, RJ, Brasil.ORCID http://orcid.org/0000-0002-7638-6814
Clemax Couto Sant'AnnaUniversidade Federal do Rio de Janeiro. Programa de Pós-graduação em Clínica Médica. Rio de Janeiro, RJ, Brasil.ORCID http://orcid.org/0000-0001-8732-8065
Elisangela Costa LimaUniversidade Federal do Rio de Janeiro. Faculdade de Farmácia. Rio de Janeiro, RJ, Brasil.ORCID http://orcid.org/0000-0002-0101-790X
Andrea Alice SilvaUniversidade Federal Fluminense. Faculdade de Medicina. Laboratório Multiusuário de Apoio à Pesquisa em Nefrologia e Ciências Médicas. Niterói, RJ, Brasil.ORCID http://orcid.org/0000-0001-5856-6128

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To explore the spatial distribution of bacille Calmette-Guerin (BCG) vaccination coverage and tuberculosis cases in Brazilian children under the age of ten in the last two decades. This is a population-based ecological study using data from the Sistema de Informação de Agravos de Notificação (SINAN - Information System for Notifiable Diseases) from January 2001 to December 2022. We investigated tuberculosis incidence and vaccination coverage in all Brazilian municipalities. Spatial dependence was analyzed by the Global Moran Index and Local Indicators of Spatial Association (LISA). Joinpoint regression was used to assess trends in tuberculosis and BCG rates over time. The results indicated 39,840 pediatric tuberculosis cases, with 60.65% in children under the age of five. The highest incidence rates were in the states of Amazonas, Mato Grosso, and Rio de Janeiro. Spatial analysis showed significant positive spatial autocorrelation in pediatric tuberculosis cases, with high-high clusters in several states and municipalities. Tuberculosis cases in children under five have been declining since 2000 but rose in 2020 (APC = 26.64; p-value = 0.032). An earlier increase was observed in children up to ten years old, starting six years prior. The study highlights the decline in BCG vaccination coverage below 90%, with the most significant drop in 2020, particularly in the Northeast. The findings underscore the need for high maintain vaccination coverage and robust public health policies to mitigate tuberculosis in children. Addressing these issues requires targeted public health interventions, especially in regions with higher tuberculosis burdens.

Indexed as

BCG VaccineTuberculosisVaccinationVaccination CoverageBrazilChildChild, PreschoolFemaleHumansIncidenceInfantInfant, NewbornMaleSpatial AnalysisSpatio-Temporal AnalysisBCG Vaccine

Identifiers

PMID40298687
PMCPMC12039808

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.