ABSTRACT
Resumen Introducción La tuberculosis es la causa principal de muerte por un solo agente infeccioso en el mundo. Anualmente, ocurren 10 millones de casos nuevos y más del 95% en países en vías de desarrollo; este problema de salud se vincula a las condiciones sociales y económicas de la población. Objetivo Analizar la relación entre el gasto en salud y la pobreza con la incidencia de tuberculosis en México. Material y métodos Investigación no experimental en el que se analizan reportes económicos y epidemiológicos de tuberculosis de México, periodo 2009-2015. Resultados El producto interno bruto (PIB) de México creció 45% en 2014 con relación al año 2009. El porcentaje del PIB invertido en salud disminuyó desde 2009, pasando de 6.2 a 5.9% en 2015. La población en pobreza aumentó de 2010 a 2014, de 46.1 a 46.2%; la pobreza extrema disminuyó de 11.3 a 9.5%. En 2015, se diagnosticaron 20,561 casos nuevos de tuberculosis, con una incidencia de 17 casos por cada 100,000 habitantes, incrementando dos décimas con relación al año previo. Conclusión El incremento de la incidencia de tuberculosis en México se relaciona con las condiciones socioeconómicas de la población. Las políticas públicas deberán atender los determinantes sociales.
Abstract Introduction Tuberculosis, the main cause of death by a single infectious agent in the world. Annually there are 10 million new cases and more than 95% in developing countries; this health problem is linked to the social and economic conditions of the population. Objective To analyze the relationship between health spending and poverty with the incidence of tuberculosis in Mexico. Material and methods Non-experimental research, analyzing economic and epidemiological reports of tuberculosis in Mexico, period 2009-2015. Results Mexico's Gross Domestic Product (GDP) grew 45% in 2014 compared to 2009. The percentage of GDP invested in health decreased since 2009, from 6.2 to 5.9% in 2015. The population in poverty increased from 2010 to 2014, from 46.1 to 46.2%; extreme poverty decreased from 11.3 to 9.5%. In 2015, 20,561 new cases of tuberculosis were diagnosed, with an incidence of 17 cases per 100,000 inhabitants, increasing two tenths in relation to the previous year. Conclusion The increase in the incidence of tuberculosis in Mexico is related to the socioeconomic conditions of the population. Public policies must address social determinants.
ABSTRACT
Background: Tuberculosis has long been recognized as a public health problem in large cities. The goals of the "Stop TB" strategy of the WHO specifically promote its study at the subnational level. Therefore, we aimed to describe the state of pulmonary tuberculosis (PTB) at the municipality level in Mexico. Methods: We obtained data on new cases of PTB and treatment success rates (TSRs) per municipality from each state in Mexico, reported by the Mexican Social Security Institute to the National Epidemiological Surveillance System during 2013. Regression model was used to quantify associations between PTB and TSR by the municipality. Results: We included 4090 cases of PTB distributed in 432 municipalities. There were 121 municipalities with TSRs < 85%. Lower TSRs were associated with older age, male sex, and comorbidities. Conclusions: Results suggest a negative outcome of PTB treatment in patients with HIV and in those with malnutrition. The number of reported cases by the municipality was not associated with a negative treatment outcome.
Subject(s)
HIV Infections/epidemiology , Malnutrition/epidemiology , Tuberculosis, Pulmonary/therapy , Adult , Age Factors , Cohort Studies , Disease Notification , Female , Humans , Male , Mexico , Middle Aged , Regression Analysis , Retrospective Studies , Risk Factors , Sex Factors , Treatment OutcomeABSTRACT
BACKGROUND: Tuberculosis and HIV remain a public health problem in developed countries. The objective of this study was to analyze the incidence trends of pulmonary TB and HIV comorbidity and treatment outcomes according to HIV during the period 2006 to 2014 in the Mexican Institute of Social Security. METHODS: Analyzed data from this registry including pulmonary tuberculosis patients aged 15 years and older who had been diagnosed during the years 2006 to 2014 in the Mexican Institute of Social Security. The outcomes that we use were incidents rate, failure to treatment and death. Regression models were used to quantify associations between pulmonary tuberculosis and HIV mortality. RESULTS: During the study period, 31,352 patients were registered with pulmonary tuberculosis. The incidence rate observed during 2014 was 11.6 case of PTB per 100,000. The incidence rate for PTB and HIV was 0.345 per 100,000. The PTB incidence rate decreased by 0.07%, differences found in the PTB incidence rate by sex since in women decreased by 5.52% and in man increase by 3.62%. The pulmonary TB with HIV incidence rate decreased by 16.3% during the study period (In women increase 4.81% and in man decrease 21.6%). Analysis of PTB associated with HIV by age groups revealed that the highest incidence rates were observed for the 30 to 44 years old group. Meanwhile, the highest incidence rates of PTB without HIV occurred among the 60 and more years old individuals. We did not find statistically significant differences between treatment failure and PTB patients with HIV and without HIV. The treatment failure was associated with sex and the region of the patient. We found a strong association between HIV and the probability of dying during treatment. Our data suggested that patients suffering from both conditions (PTB and HIV) have no difference in the probability of failure of treatment contrary to other reports. Hypotheses to this is adherence to tuberculosis treatment with people living with HIV/AIDS, detection of PTB in patients suffering from HIV/AIDS or PTB patients on antiretroviral therapy were more likely to have successful treatment outcomes than those not on antiretroviral treatment. We have found that PTB and HIV increases the probability of dying during treatment compared to the cases of PTB without HIV, consistent with published other study HIV increases the mortality rates associated with PTB. CONCLUSIONS: No association between pulmonary tuberculosis with HIV and treatment failure was observed, but pulmonary tuberculosis and HIV increases the probability of dying during treatment compared to the pulmonary tuberculosis cases without HIV.
