Tuberculosis in a Brazilian Urban Center: A Decade of Challenges and Epidemiological Trends (2014–2024)

Tuberculosis (TB) remains a major public health challenge, particularly in regions with significant social inequalities. This study characterized the epidemiological profile of TB in São José do Rio Preto, a medium-sized city in southeastern Brazil, over an 11-year period. A retrospective analysis of 2,017 cases reported between 2014 and 2024 revealed a predominance among males (male-to-female ratio of 3:1) and adults aged 25–44 years (46.9%), most of whom had not completed high school (82.3%). Pulmonary TB was the most common form (78.5%). High rates of comorbidities were observed, including diabetes (8.5%), alcohol-use disorder (22.8%), smoking (38.7%), illicit drug use (24.1%), and HIV infection (13.8%). HIV co-infection was strongly associated with extrapulmonary TB (OR = 4.3, 99% CI = 3.1–6.2), while TB-related deaths were linked to older age and diabetes (OR = 2.9, 99% CI = 1.5–5.8). Patients undergoing directly observed treatment had markedly less TB-related death (OR = 0.03; 99% CI = 0.0–0.1). These findings highlight that TB in São José do Rio Preto disproportionately affects young adult males with substantial social vulnerabilities, emphasizing the need to address social vulnerabilities and comorbid conditions in TB control efforts.