Tuberculosis among South American immigrants in São Paulo municipality: an analysis in space and time.

OBJECTIVE To identify spatial and temporal, and spatial variation in temporal trends in clusters of tuberculosis (TB) among South American migrants residing in São Paulo municipality, SP, Brazil, between 2006 and 2013. DESIGN An ecological descriptive study was conducted using data obtained from official TB reports and the 2010 Brazilian demographic census. Clusters were identified using scan statistics and SaTScan software; those with P < 0.05 were considered statistically significant. Social and economic characteristics of residents within the clusters were investigated. RESULTS One high-risk spatial cluster (relative risk [RR] 4.46, P < 0.001) for TB was identified. Bolivian immigrants comprised the majority of immigrants residing in this area. One purely temporal high-risk cluster was identified between 2011 and 2013 (RR 1.55, P = 0.001). In one of the spatial variation in temporal trends clusters, the annual increase in TB incidence was 17.54% inside the cluster and 5.17% outside. CONCLUSIONS We found areas of high risk for TB among South American immigrants. These areas and those with increasing trends of TB incidence must be prioritised by TB control programmes.