Work

Tuberculosis-related hospitalizations in Brazil: a nine-year experience in a high-burden setting

Year: 2026

Type: article

Abstract: BACKGROUND: Tuberculosis (TB) remains a major public health concern globally and in Brazil. Although ambulatory treatment is recommended for most patients, hospitalizations still occur due to severe clinical presentations, social vulnerability, or treatment complications. METHODS: We conducted a retrospective, observational study of TB-related hospitalizations at a regional referral tertiary public hospital in São Paulo, Brazil, from 2013 to 2022. Medical records were reviewed to collect epidemiological, clinical, laboratory, and microbiological data. RESULTS: . Malnutrition (40.1%), smoking (64.0%), alcohol use (51.6%), and illicit drug use (58.1%) were common. Pulmonary TB occurred in 48.7%, while 29.4% had extrapulmonary TB and 21.8% disseminated forms. Diagnostic confirmation was achieved in 74.1%, including bacilloscopy, culture, molecular test, ADA and biopsy. The main reason for hospitalization was diagnostic work-up (74.1%), with a median symptom duration of 3.6 months. ICU care was required in 23.8% of cases. In-hospital mortality was 17.3%, and significant risk factors included malnutrition and thrombocytopenia. CONCLUSIONS: In this high-burden setting, TB hospitalizations were associated with social vulnerability, HIV coinfection, and delayed diagnosis. The high frequency of severe presentations highlights the importance of early detection and access to molecular testing. Improved integration between outpatient care and hospital services may reduce the need for hospitalization and improve outcomes.

Source: The Brazilian Journal of Infectious Diseases

DOI: 10.1016/j.bjid.2026.105789