Mariana Gaspar Botelho Funari de Faria
Ribeirao Preto College of Nursing, University of Sao Paulo
Abstract Title: Temporal trends and projections of diagnostic test coverage for pulmonary tuberculosis in São Paulo, Brazil, amid the COVID-19 pandemic.
Biography: Nurse graduated in 2006. Holds a specialization in Intensive Care Nursing in 2008 and a specialization in Primary Care Nursing with emphasis on the Family Health Strategy in 2024. Earned a Master’s degree in Immunology and Basic and Applied Parasitology from the Federal University of Mato Grosso (2016–2018) and a PhD in Sciences from the Ribeirão Preto School of Nursing at the University of São Paulo (EERP-USP) (2019–2023). Currently serves as a postdoctoral researcher at EERP-USP with FAPESP funding. Member of the Operational Epidemiological Studies Group on HIV/AIDS and Tuberculosis (GEOHaids and GEOTB).
Research Interest: To analyze the temporal trend and projections of diagnostic test coverage for pulmonary tuberculosis in the state of São Paulo, Brazil. Method: This is an ecological time-series study of tuberculosis cases reported in the state of São Paulo between 2014 and 2024. Data were obtained from an information system. Coverage of smear microscopy, culture, Xpert MTB/RIF (TRM-TB), and drug-susceptibility testing was evaluated monthly and, in the case of TRM-TB, also by sex. Structural changes in the series were identified using the strucchange package, and projections of TRM-TB coverage were generated using the STLf method, combining STL decomposition and ARIMA models. Results: The study included 147,438 adults with pulmonary TB. There was a continuous decline in smear microscopy coverage (from ~95% to ~60%) and a progressive increase in TRM-TB, except for a drop in 2016–2017 due to supply shortages. Culture coverage declined after 2018, and drug-susceptibility testing decreased between 2021–2023. TRM-TB rates were similar between men and women, though slightly higher among men. Projections indicated that coverage may reach approximately 65% among men and 63% among women by 2026. Conclusion: The results show sustained growth and favorable projections for the expansion of TRM-TB in São Paulo, reinforcing its central role in TB diagnosis. Nevertheless, heterogeneity in test coverage and the reduction of complementary diagnostics, such as culture and drug-susceptibility testing, highlight the need to integrate molecular and conventional methods to ensure comprehensive diagnosis, monitor resistance, and support progress toward achieving TB elimination goals by 2035.