Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health.

Background: The objective of this study was to identify which air pollutants, atmospheric variables and health determinants could influence COVID-19 mortality in Spain. This study used information from 41 of the 52 provinces in Spain (from Feb. 1, to May 31, 2021). Generalized Linear Models (GLM) with Poisson link were carried out for the provinces, using the Rate of Mortality due to COVID-19 (CM) per 1,000,000 inhabitants as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). The GLM model controlled for trend, seasonalities and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 g/m3 in PM10 and NO2 and by 1 â„ƒ in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health. Results: Statistically significant associations were found between PM10, NO2 and the CM. These associations had a positive value. In the case of temperature and humidity, the associations had a negative value. PM10 being the variable that showed greater association, with the CM followed of NO2 in the majority of provinces. Anyone of the health determinants considered, could explain the differential geographic behavior. Conclusions: The role of PM10 is worth highlighting, as the chemical air pollutant for which there was a greater number of provinces in which it was associated with CM. The role of the meteorological variables-temperature and HA-was much less compared to that of the air pollutants. None of the social determinants we proposed could explain the heterogeneous geographical distribution identified in this study. Supplementary Information: The online version contains supplementary material available at 10.1186/s12302-022-00617-z.

Analysis of extrapulmonary tuberculosis in Spain: 2007-2012 National Study / Análisis de la tuberculosis extrapulmonar en España: Estudio Nacional 2007-2012

INTRODUCTION: This study sought to study the epidemiological characteristics of the extrapulmonary tuberculosis (EPTB) in relation to pulmonary tuberculosis (PTB) from 2007 to 2012 in Spain, and plot its trend across the same period. METHODS: We conducted an analytical cross-sectional study in which the following variables were analysed: age; sex; disease site; history of antituberculosis treatment; country of birth; presence of HIV infection; and culture results. Age-related differences were ascertained using the test of comparison of proportions, and crude and adjusted ORs were calculated using linear regression models. RESULTS: Of the total of 44,050 cases of tuberculosis reported in the period 2007-2012 and included in the study, 31,508 (71.53%) were pulmonary tuberculosis and 12,542 (28.47%) were EPTB. EPTB rates decreased across all age groups. The main EPTB risk factor was presence of HIV infection (OR 1.39). Persons aged under 65 years had a lower risk of EPTB. CONCLUSIONS: Although persons aged over 65 years displayed the highest incidence, there was nevertheless a downward trend across all age groups. Whereas children showed a significant decrease in tuberculous meningitis, this was not so for all extrapulmonary forms. EPTB rates among persons born outside Spain were much higher than those among the Spanish population

INTRODUCCIÓN: Estudiamos las características epidemiológicas de la tuberculosis extrapulmonar (TBEP) en comparación con la tuberculosis pulmonar del 2007 al 2012 en España, y argumentamos las tendencias durante el mismo período. MÉTODOS: Realizamos un estudio transversal analítico en el cual analizamos las siguientes variables: edad, sexo, lugar de la tuberculosis, historia de tratamiento antituberculosis, país de nacimiento, presencia de infección por VIH y resultados de cultivo. Se realizó el test de comparación de proporciones para determinar los diferentes grupos de edad y calcular las OR brutas y ajustadas usando modelos de regresión lineal. RESULTADOS: De un total de 44,050 casos de tuberculosis reportados en el período 2007-2012 e incluidos en el estudio, 31,508 (71.53%) fueron tuberculosis pulmonar y 12,542 (28.47%) fueron TBEP. Las tasas de TBEP disminuyeron en todos los grupos de edad. El principal factor de riesgo para TBEP fue la presencia de infección por VIH (OR 1.39). El grupo de edad de menores de 65 años tuvo un menor riesgo de TBEP. CONCLUSIONES: Aunque las personas mayores de 65 años mostraron una mayor incidencia, en general en todos los grupos de edad hubo una tendencia al descenso. Mientras en los niños se observó un descenso significativo en la meningitis tuberculosa, dicha tendencia no se observó en el resto de las formas de tuberculosis extrapulmonar. La tasa de TBEP entre las personas nacidas fuera de España fue mucho mayor que entre las personas nacidas en España

Analysis of extrapulmonary tuberculosis in Spain: 2007-2012 National Study.

INTRODUCTION: This study sought to study the epidemiological characteristics of the extrapulmonary tuberculosis (EPTB) in relation to pulmonary tuberculosis (PTB) from 2007 to 2012 in Spain, and plot its trend across the same period. METHODS: We conducted an analytical cross-sectional study in which the following variables were analysed: age; sex; disease site; history of antituberculosis treatment; country of birth; presence of HIV infection; and culture results. Age-related differences were ascertained using the test of comparison of proportions, and crude and adjusted ORs were calculated using linear regression models. RESULTS: Of the total of 44,050 cases of tuberculosis reported in the period 2007-2012 and included in the study, 31,508 (71.53%) were pulmonary tuberculosis and 12,542 (28.47%) were EPTB. EPTB rates decreased across all age groups. The main EPTB risk factor was presence of HIV infection (OR 1.39). Persons aged under 65 years had a lower risk of EPTB. CONCLUSIONS: Although persons aged over 65 years displayed the highest incidence, there was nevertheless a downward trend across all age groups. Whereas children showed a significant decrease in tuberculous meningitis, this was not so for all extrapulmonary forms. EPTB rates among persons born outside Spain were much higher than those among the Spanish population.