Abstract

CASTILLA, J. et al. Evolution of the epidemiological characteristics of tuberculosis in Navarra (1994-2003). Anales Sis San Navarra [online]. 2005, vol.28, n.2, pp.237-245. ISSN 1137-6627.

Aim. To describe the changes in the incidence and the epidemiological profile of tuberculosis in Navarra.  Methods. The cases of tuberculosis in the 1994-2003 period were analysed. Cases reported to the system of obligatory notifiable diseases, completed with the microbiological diagnoses and the cases collected in other health registers.  Results. The incidence of tuberculosis fell from 21 per 100,000 inhabitants in the five-year period 1994-1998 to 16 per 100,000 in 1999-2003. In both periods the number of cases in men doubled that in women, and the maximum incidence occurred in the age groups from 25 to 44 and over 65 years of age. The diagnoses of tuberculosis in persons with HIV infection fell from 15.1% to 6.6% and those in immigrants rose from 2.2% to 21.3%. Somewhat over 3% of the cases had received prior anti-tuberculosis treatment and about 6% showed resistance to some medicine, without significant differences between periods. The proportion of potentially transmissible tuberculosis (73%) underwent no significant changes, nor did that of those with positive sputum bacilloscopy. The number of outbreaks (groupings of two or more cases) rose from 18 to 26 and the percentage of cases secondary to another recent case rose from 3.6% to 10.1% (p<0,001).  In the 1999-2003 period, pulmonary localisation occurred in isolated form in 67.7% of the patients, and in combination with other localisations in another 5.1%. The isolated pleural form appeared in 9.9% and the meningeal form in 1.5%.  Conclusion. There has been an advance in the control of tuberculosis although its incidence is still high with respect to other European countries. Control of imported cases is one of the challenges to be faced in coming years, without neglecting control measures in the autochthonous population.

Keywords : Tuberculosis; Immigration; Human immunodeficiency virus; Epidemiology; Resistance.

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