{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T03:57:42Z","timestamp":1780977462484,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary tuberculosis (PTB) remains a major public health problem, strongly associated with social and territorial inequalities. This study aimed to analyse temporal trends, spatiotemporal transmission patterns and socioeconomic determinants of PTB in the state of Piau\u00ed, Northeast Brazil, from 2001 to 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An ecological study was conducted using official surveillance data on newly reported PTB cases at the municipal level. Temporal, spatial and spatiotemporal analytical methods were applied to investigate long\u2010term trends, transmission patterns and socioeconomic determinants associated with PTB incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 17,186 PTB cases were reported. Time\u2010series analysis showed a sustained decline in incidence between 2001 and 2015, followed by a period of gradual recovery starting in 2016. Seasonality remained stable, with peaks occurring between April and June. Persistent spatial heterogeneity was identified, with higher\u2010risk clusters concentrated in urban municipalities. Multivariate spatiotemporal time\u2010series analysis revealed the predominance of the endemic component, with a secondary contribution from the autoregressive component and minimal contribution from the spatiotemporal component. In the spatial Bayesian analysis, PTB incidence was associated with AIDS incidence (Relative Risk [RR]\u2009=\u20091.11; 95% Credible Interval [CrI]: 1.05\u20131.18), the number of nurses per 1000 inhabitants (RR\u2009=\u20091.08; 95% CrI: 1.03\u20131.13) and per capita municipal health expenditure (RR\u2009=\u20090.94; 95% CrI: 0.89\u20130.98).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PTB in the Piau\u00ed exhibited heterogeneous spatiotemporal patterns, being sustained primarily by endemic factors and persistent structural inequalities. Control strategies should be territorially targeted, considering local transmission patterns and the identified determinants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70133","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T09:30:32Z","timestamp":1774085432000},"page":"754-765","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatiotemporal Patterns and Socioeconomic Determinants of Pulmonary Tuberculosis in Piau\u00ed, Northeast Brazil, 2001\u20132024"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6674-0939","authenticated-orcid":false,"given":"Jos\u00e9 M\u00e1rio Nunes","family":"da Silva","sequence":"first","affiliation":[{"name":"Centre for Tropical Medicine, School of Medicine University of Bras\u00edlia  Bras\u00edlia DF Brazil"},{"name":"Laborat\u00f3rio de Infer\u00eancia Causal Em Epidemiologia (LINCE\u2010USP), School of Public Health University of S\u00e3o Paulo  S\u00e3o Paulo SP Brazil"},{"name":"N\u00facleo de Ensino e Pesquisa em Tuberculose Federal University of Piau\u00ed  Teresina PI Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7515-2389","authenticated-orcid":false,"given":"Viriato","family":"Campelo","sequence":"additional","affiliation":[{"name":"N\u00facleo de Ensino e Pesquisa em Tuberculose Federal University of Piau\u00ed  Teresina PI Brazil"},{"name":"Department of Parasitology and Microbiology Federal University of Piau\u00ed  Teresina PI Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-5670","authenticated-orcid":false,"given":"Walter Massa","family":"Ramalho","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine, School of Medicine University of Bras\u00edlia  Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Global tuberculosis report 2025","author":"World Health Organization","year":"2025"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003425"},{"key":"e_1_2_11_4_1","volume-title":"Boletim epidemiol\u00f3gico \u2010 tuberculose 2025","author":"Minist\u00e9rio da Sa\u00fade do Brasil","year":"2025"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0339784"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/traf136"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40249\u2010025\u201001400\u2010x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0247894"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1590\/1413\u201081232025307.15972023en"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2013.10.008"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102024\u2010085733"},{"key":"e_1_2_11_12_1","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica \u201cBrasil em s\u00edntese [Internet] \u201d2022[cited 2025 May 5] https:\/\/brasilemsintese.ibge.gov.br\/."},{"key":"e_1_2_11_13_1","volume-title":"Global Programme on Evidence for Health Policy Discussion Paper Series: no. 31","author":"Ahmad O. 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