Multidrug-Resistant Tuberculosis in East Lima: Analysis of Geographic Distribution, Epidemiological Profile, and Temporal Trends
Tuberculosis multirresistente en Lima Este: Análisis de la distribución territorial, perfil epidemiológico y tendencia temporal
DOI:
https://doi.org/10.22258/hgh.v10i2.417Abstract
Objective: To analyze the epidemiological profile, temporal trends, and geographic distribution of multidrug-resistant tuberculosis (MDR-TB) across districts of the Integrated Health Networks Directorate (DIRIS) East Lima, Peru, during the 2015–2019 period. Materials and Methods: A retrospective observational study was conducted using records from the Tuberculosis Management Information System (SIGTB). All reported MDR-TB cases within the East Lima jurisdiction were included, and cumulative incidence rates (CIR) per 100,000 population were calculated. Temporal trends were assessed using linear regression models. Spatial distribution was described through thematic mapping developed in R software. Results: A total of 723 MDR-TB cases were analyzed. Of these, 58.7% (n=424) were young adults (18–30 years), and 63.8% (n=463) were male. Additionally, 64.8% (n=469) were new cases, suggesting substantial community transmission. No significant temporal trend was observed during the study period (p = 0.42). Marked spatial heterogeneity was identified: El Agustino had the highest CIR (113.76 per 100,000), 15.6 times higher than La Molina (7.3 per 100,000). Furthermore, 90.3% (n=652) of cases belonged to middle, lower-middle, or low socioeconomic strata. Conclusions: MDR-TB in East Lima shows a stable incidence but a highly unequal spatial distribution, concentrated in districts with structural vulnerability. These findings highlight the need to implement targeted interventions and prioritize resource allocation. Key words: Tuberculosis, Multidrug-Resistant; Geographic Mapping; Epidemiologic Studies; Geographic Information Systems; Peru (Source: MeSH, NLM).Downloads
References
World Health Organization. Global tuberculosis report 2020. Geneva; 2020. https://www.who.int/publications/i/item/9789240013131
Lv H, Zhang X, Zhang X, Bai J, You S, Li X, et al. Global prevalence and burden of multidrug-resistant tuberculosis from 1990 to 2019. BMC Infect Dis. 2024;24(243). DOI:10.1186/s12879-024-09079-5.
Tan EL, Qin Y, Yang J, Li XJ, Liu TQ, Yang GB, et al. Global burden of MDR-TB and XDR-TB: trends, inequities, and future implications for public health planning. BMC Infect Dis. 2025;25(1225). DOI:10.1186/s12879-025-11566-2.
Farkhan A, Lawpoolsri S, Soonthornworasiri N, Pakasi TT, Sulistyo S, Salsabila A, et al. Spatiotemporal epidemiology, geographic hotspots, and risk factor associations of drug-resistant tuberculosis incidence in Indonesia: a Bayesian hierarchical modelling approach. Infect Dis Poverty. 2026;15(23). DOI:10.1186/s40249-026-01418-9.
World Health Organization. Global tuberculosis report 2025. World Health Organization. Geneva; 2025 https://iris.who.int/server/api/core/bitstreams/e97dd6f4-b567-4396-8680-717bac6869a9/content
Dirección de Prevención y Control de la Tuberculosis. MINSA - DPCTB: Portal de Información. Perfil de Tuberculosis. 2015. https://www.tuberculosis.minsa.gob.pe/DashboardDPCTB/PerfilTB.aspx
Renjifo Ramos PC. Situación Epidemiológica de la TBC en el Perú. Centro Nacional de Epidemiología, Prevención y Control de Enfermedades. Lima; 2022. http://www.dge.gob.pe/portal/docs/tools/teleconferencia/2022/SE272022/03.pdf
Bernal O, López R, Montoro E, Avedillo P, Westby K, Ghidinelli M. Determinantes sociales y meta de tuberculosis en los Objetivos de Desarrollo Sostenible en las Américas. Rev Panam Salud Pública. 2020;44:1–8. DOI:10.26633/RPSP.2020.153
Teibo Ayandeyi TK, de Paula Andrade RL, Rosa RJ, Vaz Tavares RB, Zamboni Berra T, Arcêncio RA. Geo-spatial high-risk clusters of Tuberculosis in the global general population: a systematic review. BMC Public Health. 2023;23:1586. DOI: 10.1186/s12889-023-16493-y
Ávalos Rodríguez AC, Imán Izquierdo FJC, Virú Loza MA, Cabrera Rivero J, Zárate Robles AE, Meza Monterrey MC, et al. Factores asociados a tuberculosis multidrogorresistente primaria en pacientes de Callao, Perú. An Fac Med. 2014;75(3):233–6. DOI:10.15381/anales.v75i3.9775
Alarcón V, Alarcón E, Figueroa C, Mendoza-Ticona A. Tuberculosis en el Perú: Situación epidemiológica, avances y desafíos para su control. Rev Peru Med Exp Salud Publica. 2017;34(2):299. DOI:10.17843/rpmesp.2017.342.2384
Carrasco-Escobar G, Schwalb A, Tello-Lizarraga K, Vega-Guerovich P, Ugarte-Gil C. Spatio-temporal co-occurrence of hotspots of tuberculosis, poverty and air pollution in Lima, Peru. Infect Dis Poverty. 2020;9(1):32. DOI:10.1186/s40249-020-00647-w
Leveri TH, Lekule I, Mollel E, Lyamuya F, Kilonzo K. Predictors of Treatment Outcomes among Multidrug Resistant Tuberculosis Patients in Tanzania. Tuberc Res Treat. 2019;2019(3569018):1–10. DOI:10.1155/2019/3569018
Ministerio de Salud. Decreto Supremo No 026-2020-SA. Política Nacional Multisectorial de Salud al 2030 “Perú, país saludable”. Diario El Peruano. 2020 Aug 24. https://busquedas.elperuano.pe/api/visor_html/2255412-3
Montalvo-Otivo R, Ramírez-Breña M, Bruno-Huamán A, Damián-Mucha M, Vilchez-Bravo S, Quisurco-Cárdenas M. Distribución geográfica y factores de riesgo de tuberculosis multidrogorresistente en el centro de Perú. Rev Fac Med. 2020;68(2):245–50. DOI: 010.15446/revfacmed.v68n2.71715
Valbuena-García AM, Rodríguez-Villamizar LA. Análisis espacial en epidemiología: revisión de métodos. Rev Salud UIS. 2018;50(4):358–65. DOI:10.18273/revsal.v50n4-2018009
Alene KA, Viney K, McBryde ES, Clements ACA. Spatial patterns of multidrug resistant tuberculosis and relationships to socio-economic, demographic and household factors in northwest Ethiopia. Neyrolles O, editor. PLoS One. 2017;12(2):e0171800. DOI:10.1371/journal.pone.0171800
World Health Organization. Global tuberculosis report 2024. World Health Organization. Geneva; 2024 http://www.who.int/tb/publications/global_report/en/index.html
Teibo Ayandeyi TK, Berra TZ, Alves YM, Tavares RBV, Olayemi OA, Arcêncio RA. Surveillance of tuberculosis incidence and mortality through spatio-temporal analysis in Oyo State, Nigeria. Yaro CA, editor. PLoS One. 2025;20(7):e0311739. DOI:10.1371/journal.pone.0311739
Dirección de Prevención y Control de la Tuberculosis. Sala Situacional de Tuberculosis Drogo Resistente 2024. Ministerio de Salud. http://www.tuberculosis.minsa.gob.pe/DashboardDPCTB/recursos/20250702083843.pdf
Instituto Nacional de Estadística e Informática. Mapa de pobreza monetaria provincial y distrital 2018. Lima: INEI; 2020. 1–303 p. https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1718/Libro.pdf
Instituto Nacional de Estadística e Informática. Sistema de Información Distrital para la Gestión Pública – EstaDist. 2025. https://estadist.inei.gob.pe/
Oficina de Epidemiología Inteligencia Sanitaria y Docencia e Investigación. Análisis Situacional de Salud DIRIS Lima Este, 2025. Dirección de Redes Integradas de Salud de Lima Este. Lima; 2025 Oct. https://www.gob.pe/institucion/dirislimaeste/informes-publicaciones/7695131-analisis-de-situacion-de-salud-de-diris-lima-este-2025
Instituto Nacional de Estadística e Informática. Planos Estratificados de Lima Metropolitana a Nivel de Manzanas 2020 según ingreso per cápita del hogar. Lima: INEI; 2020. 1–74 p. https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1744/libro.pdf
Ministerio de Salud. Modificatoria de la NTP No 104 V.01 Norma Técnica de Salud para la atención integral de las personas afectadas por tuberculosis. Lima, Perú: Ministerio de Salud; 2018. https://cdn.www.gob.pe/uploads/document/file/186939/Resolucion_Ministerial_752-2018-MINSA.PDF?v=1664574455
Instituto Nacional de Estadística e Informática. Provincia de Lima. En: Resultados Definitivos de los Censos Nacionales 2017 – Censos Nacionales 2017. Lima: Instituto Nacional de Estadística e Informática; 2018. p. 1–1101. https://censo2017.inei.gob.pe/resultados-definitivos-de-los-censos-nacionales-2017/
Informe Belmont: Principios éticos y normas para el desarrollo de las investigaciones que involucran a seres humanos. Rev Médica Hered. 2013;4(3):1–11. DOI:10.20453/rmh.v4i3.424
Rapid Research for Diagnostics Development in TB Network. R2D2 TB Network - Peru. 2019. https://www.r2d2tbnetwork.org/what-we-do/clinical-sites/peru?utm_source=chatgpt.com
World Health Organization. Global tuberculosis report 2019. Geneva; 2019. https://www.who.int/publications/i/item/9789241565714
Rodriguez Rivero L, Corzo Nicolini DR, Desmaison Estrada B. Entender la desigualdad urbana en Lima Metropolitana: historia, multidimensionalidad y pistas para combatirla. https://revistas.pucp.edu.pe/index.php/ensayo/article/download/28240/26172/112201
De Abreu e Silva M, Di Lorenzo Oliveira C, Teixeira Neto RG, Camargos PA. Spatial distribution of tuberculosis from 2002 to 2012 in a midsize city in Brazil. BMC Public Health. 2016;16(1):912. DOI:10.1186/s12889-016-3575-y
Barletta F, Otero L, de Jong BC, Iwamoto T, Arikawa K, Van der Stuyft P, et al. Predominant Mycobacterium tuberculosis Families and High Rates of Recent Transmission among New Cases Are Not Associated with Primary Multidrug Resistance in Lima, Peru. J Clin Microbiol. 2015;53(6):1854–63. DOI:10.1128/JCM.03585-14.
Lucena LA de, Dantas GB da S, Carneiro TV, Lacerda HG. Factors Associated with the Abandonment of Tuberculosis Treatment in Brazil: A Systematic Review. Rev Soc Bras Med Trop. 2023;56(e0155-2022):1–7. DOI:10.1590/0037-8682-0155-2022
Castro Gálvez J. Factores pronósticos asociados al abandono, muerte y fracaso del tratamiento de tuberculosis en niños y adolescentes del Programa de Tuberculosis del Hospital Cayetano Heredia en el periodo de 1980-2012. Universidad Peruana Cayetano Heredia; 2019. https://repositorio.upch.edu.pe/bitstream/handle/20.500.12866/5971/Factores_CastroGalvez_Javier.pdf?sequence=3&isAllowed=y
World Health Organization. Global tuberculosis report 2022. Geneva; 2022. https://www.who.int/publications/i/item/9789240061729
Roy N, Basu M, Das S, Mandal A, Dutt D, Dasgupta S. Risk factors associated with default among tuberculosis patients in Darjeeling district of West Bengal, India. J Fam Med Prim Care. 2015;4(3):388-94. DOI:10.4103/2249-4863.161330
Dirección de Prevención y Control de la Tuberculosis. Sala Situacional de Tuberculosis Drogo Resistente 2023. Lima; 2023. http://www.tuberculosis.minsa.gob.pe/portaldpctb/Contenido.aspx?op=2029
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