TUBERCULOSIS IN CHILDREN UNDER 5 YEARS OF AGE IN THE STATE OF GOIÁS: EPIDEMIOLOGICAL ANALYSIS AND IMPACT OF BCG VACCINATION COVERAGE

Abstract

Tuberculosis (TB) is one of the world's leading infectious diseases, responsible for high morbidity and mortality, especially in children under 5 years of age, a vulnerable population due to the immaturity of the immune system and the difficulty of early diagnosis. The disease, caused by Mycobacterium tuberculosis, predominantly affects the lungs but can affect other organs, especially in children, in whom extrapulmonary forms are more common and severe. According to the World Health Organization, in 2022, approximately 1.3 million cases of TB occurred in children under 14 years of age, highlighting the severity of the problem in this population. In this sense, this study aims to analyze the epidemiological profile of individuals under 5 years of age affected by tuberculosis in the state of Goiás in the last 10 years and to evaluate the impact of BCG vaccination coverage on the incidence of these cases. This descriptive, quantitative, and retrospective study uses secondary data collected from the Notifiable Diseases Information System (SINAN) and the National Immunization Program Information System (SI-PNI), made available by DATASUS. The results indicate a significant increase in childhood TB cases during the period, with growth of over 300% between 2014 and 2023. At the same time, BCG vaccination coverage showed a significant decrease, from 115.49% in 2014 to 70.67% in 2023. Among the cases analyzed, 70.64% were of the pulmonary form of the disease, predominating in male children (55.05%) and brown children (59.63%). The Central-West macro-region concentrated most of the notifications (51%), reflecting possible regional inequalities in access to vaccination and health care. This inversely proportional relationship between vaccination coverage and the incidence of TB in children reinforces vaccination's crucial role in preventing the disease. The drop in immunization compromises protection against severe forms of TB, especially in this population. In addition, socioeconomic and regional factors and the impact of events such as COVID-19 may have contributed to the reduction in vaccination coverage and the consequent increase in childhood vulnerability. Thus, low vaccination coverage is a determining factor for the increase in cases of childhood TB in Goiás. To face this challenge, it is essential to strengthen public policies aimed at raising awareness about the importance of vaccination, in addition to implementing educational campaigns and preventive strategies. Improving access to health services, prioritizing early diagnosis, and intensifying epidemiological surveillance actions are crucial measures to reverse the increase in TB in children and reduce its morbidity and mortality.