Tuberculosis (TB) is an infectious disease of relevance in Brazil, with greater impact in vulnerable urban areas. Salvador stands out among Brazilian capitals with high incidence rates, reflecting social inequalities and challenges in disease control. This study aimed to describe the evolution of TB incidence in Salvador between 2001 and 2024. Time-series study using data on new TB cases reported to SINAN/DATASUS in Salvador from 2001 to 2024. Joinpoint regression was applied to evaluate Annual Percent Change (APC) and Average Annual Percent Change (AAPC). Incidence was calculated per 100,000 inhabitants, with 95% confidence intervals and significance defined as p<0.05. Analyses were performed using the Joinpoint Regression Program, version 5.4.0 (National Cancer Institute). A total of 47,704 new cases were reported, predominantly among males (62.4%) and individuals of Black race/color (66.2%). Pulmonary TB accounted for 82.7% of cases, and extrapulmonary TB for 14.4%. Incidence rates ranged from 92.8 per 100,000 inhabitants in 2001 to 35.1 in 2024, with a peak in 2003 (116.3/100,000). Joinpoint regression identified a significant change in trend from 2003 onward, shifting from increasing to decreasing rates. From 2001 to 2003, there was a non-significant annual increase (APC=+6.96%; p=0.354). From 2003 to 2024, there was a significant annual decline of -4.02% (95% CI: -6.78 to -3.48; p=0.016). Overall, the AAPC was -3.1% (95% CI: -4.05 to -2.48; p<0.0001), indicating a sustained and statistically significant reduction in TB incidence in the capital of Bahia. Time-series analysis showed a significant and sustained reduction in TB incidence in Salvador between 2001 and 2024, particularly after 2003, when the trend shifted from growth to decline. Nevertheless, the disease remains highly prevalent among males and Black individuals, reflecting social inequalities and the need for public policies focused on vulnerable populations. The results reinforce the importance of strengthening surveillance strategies, early diagnosis, and appropriate treatment to advance TB control in Salvador.
Vieira et al. (Sun,) studied this question.