Tuberculosis is an infection of epidemiological relevance caused by Mycobacterium tuberculosis, which predominantly affects the pulmonary parenchyma but can involve other organs, such as the central nervous system (CNS). The pulmonary form is the most prevalent and the main route of transmission, whereas the neuroinvasive presentation, although less common, is associated with greater severity, risk of sequelae, and higher case fatality. Analyzing these indicators helps to understand clinical impact and to guide public policies. The aim of this study is to describe and compare the epidemiological profiles of pulmonary tuberculosis and tuberculosis of the nervous system in Brazil, focusing on the indicators ‒ hospitalizations, case fatality, and geographic distribution. This is an ecological study using secondary, publicly accessible data obtained from the Sistema de Informação de Agravos de Notificação (SINAN). Hospitalizations occurring between January 2019 and January 2025 were analyzed, according to ICD-10 codes ‒ Pulmonary tuberculosis and Tuberculosis of the nervous system. The following variables were included: number of hospitalizations, deaths, case fatality, age group, sex, race, and major region of Brazil. The case fatality rate was calculated by dividing the number of deaths by the total number of affected individuals and multiplying by 100. During the analyzed period, there were 63,743 hospitalizations and 5,818 deaths due to pulmonary tuberculosis (case fatality of 9.13%) and 2,100 hospitalizations with 237 deaths due to CNS tuberculosis (case fatality of 11.29%). Both forms predominated among adult and older men, with 47,528 hospitalizations for pulmonary tuberculosis and 1,367 for CNS tuberculosis. The most affected age group was 40–49 years for the pulmonary form (13,968 cases) and 30–39 years for the neuroinvasive form (442 cases). The Southeast region accounted for most hospitalizations and deaths: 44.6% and 48.3% in the pulmonary form (28,437 and 2,811), and 47.5% and 51.5% in the CNS form (998 and 122). Regarding race, the highest proportion occurred among people self-declared as mixed race (parda) (31,089 and 1,029 hospitalizations), followed by White individuals (15,832 and 636). Pulmonary tuberculosis showed a higher absolute number of hospitalizations and deaths, while the neurological form demonstrated higher case fatality. Both predominantly affected adult and older men, with a predominance among individuals self-declared as mixed race.
Pietsch et al. (Sun,) studied this question.