Epidemiological Profile and Impact of the Pandemic on Hospitalizations for Osteoarticular Tuberculosis in Brazil: A Time-Series Analysis

Osteoarticular tuberculosis, although accounting for only 1–3% of tuberculosis cases in Brazil, represents an important public health issue due to diagnostic complexity, high potential for sequelae, and significant impact on healthcare systems, including prolonged hospitalizations and high costs. This study aimed to analyze temporal trends in hospitalizations for bone and joint tuberculosis within the Brazilian Unified Health System (SUS) between 2014 and 2024. An observational epidemiological time-series study analyzing hospitalizations for osteoarticular tuberculosis in Brazil from 2014 to 2024. Data were obtained from the Hospital Information System of SUS (SIH/SUS) via the DATASUS TABNET platform, using ICD-10 codes corresponding to osteoarticular tuberculosis (A18). Between 2014 and 2024, 1,080 hospitalizations for osteoarticular tuberculosis occurred in Brazil. The pre-pandemic period (2014–2019) showed a mean of 93 cases/year, ranging from 68 (2018) to 106 (2017), with 100 cases in 2014. In 2020, the lowest number was recorded (64 cases; -37% compared to 2019), followed by recovery in 2021 (109 cases) and a peak in 2022 (131 cases). In 2024 (102 cases), hospitalizations remained 10% above the pre-pandemic average, indicating a lasting pandemic impact. Of the total hospitalizations, 67.9% occurred in males and 32.1% in females, with a male-to-female ratio of 2.1:1. Adults aged 30–59 years accounted for 52.1% of cases, with a peak in the 50–59 age group. Young adults (20–29 years) represented 9.4%, older adults (≥60 years) 23%, and children (<15 years) 11.5%, most frequently aged 1–4 years. Osteoarticular tuberculosis in Brazil predominantly affects adult men, with hospitalization rates remaining 10% above pre-pandemic levels in 2024. These findings highlight the need for targeted strategies for early diagnosis and continuous surveillance within the SUS.