Prevención del menor frente al tabaquismo / Prevention of the smoking habit in the minor

No disponible

Burden and Characteristics of the Comorbidity Tuberculosis-Diabetes in Europe: TBnet Prevalence Survey and Case-Control Study.

BACKGROUND: The growing burden of diabetes mellitus (DM) is posing a threat to global tuberculosis (TB) control. DM triples the risk of developing TB, modifies the presenting features of pulmonary TB, and worsens TB treatment outcomes. We aimed to analyze the prevalence of DM among TB patients and to describe the characteristics and clinical presentation of TB-DM patients in Europe. METHODS: We performed a cross-sectional survey on the prevalence of DM among consecutively diagnosed adult TB patients in 11 European TB referral centers located in France, Germany, Greece, Italy, Russia, Slovakia, Spain, and the United Kingdom over the period 2007-2015. We also selected DM-TB cases and TB only controls with a 1:3 ratio to perform a case-control analysis, including patients selected from the countries mentioned above plus Norway and Ukraine. RESULTS: Among 3143 TB enrolled patients, DM prevalence overall was 10.7% and ranged from 4.4% in Greece to 28.5% in the United Kingdom. Patients' median ages ranged from 36 to 49 years, and all centers had >60% males; the proportion of foreign-born patients varied widely across sites. In the case-control study, DM was independently associated with older age and, among older patients, with being foreign-born. Among patients with pulmonary involvement, cavities on chest imaging were more frequently observed among those with DM. CONCLUSIONS: Diabetes mellitus represents a challenge for TB control in Europe, especially in foreign-born and in elderly patients. Specific screening strategies should be evaluated.

Prevención y control de la tuberculosis / No disponible

La tuberculosis en España no está controlada. La estrategia básica para el Control de la TB es interrumpir la transmisión del Mycobacterium tuberculosis para lo cual es necesario disminuir el retraso diagnóstico de los enfermos y el inicio precoz del tratamiento. El diagnóstico de un caso de tuberculosis debe seguirse del Estudio Convencional de Contactos según el principio de “la piedra sobre el estanque” con el objetivo de detectar los individuos que han estado expuestos a la transmisión de la infección y que deben ser evaluados para detectar a infectados y enfermos y proporcionarles el tratamiento adecuado para cortar la cadena de transmisión. El tipado genómico de las cepas de M. tuberculosis aisladas en los enfermos es una herramienta imprescindible para el control de la tuberculosis a pesar de sus limitaciones actuales puesto que permite conocer los patrones de transmisión de la infección en la comunidad. La vacunación antituberculosa actualmente disponible no evita los casos de tuberculosis que son fuentes de infección, por lo que no tiene utilidad en el control de la TB y como medida de prevención su eficacia es limitada al no poseer el bacilo BCG los antígenos inmunodominantes de M. tuberculosis (AU)

Tuberculosis is out of control in Spain. The basic tool to Control TB is to interrupting the Mycobacterium tuberculosis’ transmission, diagnostic delay must be lowered and their treatment must be early started. After the diagnosis of a tuberculosis case a Contact Tracing Investigation must be started following the so-called “stone in the pond” approach to detect infected or diseased individuals and to treat them appropriately to break off the chain transmission. The genotyping of Mycobacterium tuberculosis isolates has been widely used as a main technique in epidemiologic surveillance to know the transmission dynamics of M. tuberculosis in the community, but at present there are some limitations. Vaccination against tuberculosis at present don’t prevent the occurrence of tuberculosis infectious cases and thus there is no utility as control tool, as preventive strategy have limited utility because M. bovis BCG has not the immune-dominant antigens of M. tuberculosis (AU)