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Vol. 39. Issue 10.
Pages 455-463 (October 2003)
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Vol. 39. Issue 10.
Pages 455-463 (October 2003)
Tuberculosis Control in the Central Health Region of Catalonia During the Period 1986-2000
El control de la tuberculosis en la Región Sanitaria Centro de Cataluña durante el período 1986-2000
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P. Miret Cuadrasa, JM. Pina Gutiérreza, JL. López Sanmartína, MR. Sala Farréb
a Programa de la Tuberculosi de la Regió Sanitària Centre, Institut Català de la Salut, Subdivisió d'Atenció Primària Àmbit Centre,Servei Català de la Salut, Regió Sanitària Centre, Catalunya, Spain.
b Unitat de Vigilància Epidemiològica Regió Centre, Departament de Sanitat i Seguretat Social, Delegació Territorial a Barcelona, Generalitat de Catalunya, Barcelona, Spain.
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Figure 1. Central Health Region of Catalonia.
Figure 2. Tuberculosis in the Central Health Region. Incidence rate of new cases among people born in Spain, 1986-2000.
TABLE 1. Tuberculosis in the Central Health Region, 1986-2000. Cases Reported
TABLE 2. Tuberculosis in the Central Health Region, 1986-2000. Incidence of New Spanish-Born Cases
TABLE 3. Tuberculosis in the Central Health Region, 1986-2000. New Cases Among People Born in Spain Associated With AIDS*
Figure 3. Tuberculosis in the Central Health Region. Evolution of the number of new cases among people born in Spain by age groups, 1986-2000.
Figure 4. Tuberculosis in the Central Health Region. New cases among people born in Spain, with and without acquired immuno deficiency syndrome (AIDS), 1986-2000.
Figure 5. Tuberculosis in the Central Health Region. New cases among people not born in Spain, 1986-2000.
TABLE 4. Tuberculosis in the Central Health Region, 1986-2000. Final Outcome of Treatment and Monitoring of New Cases of Tuberculosis With Positive Sputum Smear (Spanish-born and Foreign-born)*
TABLE 5. Tuberculosis in the Central Health Region, 1986-2000. Final Outcome of Treatment and Monitoring in the Cases of Tuberculosis (Retreatments) with Positive Sputum Smear (Spanish- and Foreign-born)*
Figure 6. Tuberculosis in the Central Health Region. Percentage of smear-positive patients (new cases and retreatments, Spanish-born and foreign-born), with and without contact investigation (CI).
TABLE 6. Tuberculosis in the Central Health Region. Final Outcome of Treatment and Monitoring of New and Repeat Cases of Tuberculosis During the Period 1997 to 2000 (Spanish- and Foreign-born). All Cases With Final Declaration
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Objective: To assess tuberculosis control in the Central Health Region, Catalonia, Spain, from the implementation of the area's Tuberculosis Control Program in 1986 until the year 2000. Method: To study the epidemiological profile of tuberculosis and the outcome of the following control measures in sputum smear-positive patients: final outcome of treatment and monitoring, and the percentage of patients for whom a contact investigation (CI) was carried out. Tuberculosis control is considered effective if the sum of noncompliant patients, plus the cases in which treatment failed, plus the patients transferred out remains below 10% of the cohort of patients studied, and if a CI has been conducted in at least 80% of this cohort. Results: The number of cases reported was 6326, of which 7% were retreatments. A total of 5865 new cases was detected. Of these, 5652 (96%) were patients born in Spain. The number of cases reported annually peaked in 1990 (474) and then declined continuously until 2000, when it was 54% lower (220). Foreign-born patients numbered 213 (4%), and 95% of them came from countries with a high prevalence of tuberculosis. In the cohort of patients studied between 1997 and 2000, the sum of noncompliant patients, plus cases in which treatment failed, plus the patients transferred out came to 11%. Since 1994, a CI has been carried out for over 80% of patients, and this figure reached 92% in 2000. Conclusions: We consider that a substantial degree of tuberculosis control has been achieved given the decline in tuberculosis morbidity among people born in Spain, the fact that the percentage of noncompliant patients, treatment failures and transfers was only slightly over 10%, and that a CI has been conducted for over 80% of patients since 1994 (92% in 2000).
Keywords:
Tuberculosis
Anti-tuberculosis program
Treatment adherence
Contact investigation
Objetivo: Valorar el control de la tuberculosis en la Región Sanitaria Centro de Cataluña desde el inicio de su Programa de la Tuberculosis en 1986 hasta 2000. Método: Estudio de la evolución epidemiológica de la tuberculosis y el resultado de las siguientes medidas de control en los enfermos con baciloscopia de esputo positiva: resultado final de su seguimiento y tratamiento y porcentaje de enfermos con estudio de contactos (EC). Se considera que el control de la tuberculosis es correcto cuando la suma de no cumplidores del tratamiento, fracasos terapéuticos y traslados no supera el 10% de la cohorte de enfermos estudiados y si se ha realizado el EC en, al menos, el 80% de estos enfermos. Resultados: El número de enfermos declarados fue de 6.326, y el porcentaje de retratamientos, del 7%. Se encontraron 5.865 casos nuevos. La cifra de los pacientes nacidos en España fue de 5.652 (96%) y el año 1990 fue en el que se presentaron más notificaciones (474) con descenso continuado del 54% hasta 2000 (220). La cifra de los pacientes nacidos fuera de España fue de 213 (4%), de los que el 95% procedía de países de alta prevalencia tuberculosa. En la cohorte de enfermos de 1997-2000, la tasa de no cumplidores, traslados y fracasos fue del 11%. En cuanto a los enfermos con EC, desde 1994 se venía superando el 80% hasta alcanzar el 92% en 2000. Conclusiones: Dada la tendencia descendente de la morbilidad tuberculosa en los nacidos en España, la muy discreta elevación por encima del 10% de no cumplidores, traslados y fracasos y haber superado el 80% de enfermos con EC desde 1994 hasta alcanzar el 92% en 2000, consideramos que se ha logrado un notable grado de control de la tuberculosis.
Palabras clave:
Tuberculosis
Programa antituberculoso
Cumplimiento del tratamiento
Estudio de contactos

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