Assessment of Tuberculosis incidence and treatment success rates of the indigenous Maká community in Paraguay

Setting: In Paraguay, 1.8% of the population are indigenous people. The Maka community mainly live in urbanized areas in the Central Region. This study focuses on the epidemiology of tuberculosis (TB) among indigenous Maka and the non-indigenous people living in the Central Region, the biggest metropolitan area of the Paraguay. Objectives: This study aims to analyze the TB incidence and treatment success rate of the urbanized Maka indigenous population Design: Retrospective cohort study of 6,147 registered TB patients with 387 Maka indigenous people, from 2005-2017. Results: Compared to the non-indigenous population in the Central Region, the Maka had a 66 times higher TB incidence, a lower median age at diagnosis (3 vs. 33 years; P<0.001), less bacteriological diagnosis (55.0% vs. 77.8%; P<0.001), and a higher treatment success rate of 75.2% vs. 67.8%. Directly observed therapy coverage was higher among the Maka (89.4% vs. 47.1%; P<0.001). Conclusions: The Maka showed a disproportionately high TB incidence in children. Treatment success rates did not reach the WHO standards of 85%. If the diagnosis in children from this period can be confirmed, the public health system should intensify their focus on the Maka, increasing case finding and contact tracing activities in the whole population.