Estimated incidence of tuberculosis by capture-recapture in the Balearic Islands, 2010-2012.

SETTING: The Balearic Islands, Spain, 2010-2012. OBJECTIVE: To assess the completeness of TB surveillance, and to examine observed and estimated incidence rates (IR) compared with the period 2005-2007. DESIGN: The completeness of TB surveillance was assessed using the capture-recapture method. Confidence intervals were calculated using log-linear models. Data sources were records of mandatory notifiable diseases, active hospital surveillance and computerised primary health care history. RESULTS: Surveillance completeness for respiratory TB (R-TB) was 99.5%; it was 100% for non-respiratory TB (NR-TB). The overall observed IR was 16.32 cases/100 000 for all types of TB, 3.4 for NR-TB and 12.9 for R-TB. The estimated IR of TB all forms was 16.35/100 000 (95%CI 16.26-16.53), for NR-TB it was 3.4/100 000 (95%CI not calculated) and for R-TB it was 13.0/100 000 (95%CI 12.85-13.12). Surveillance completeness for R-TB during the period 2005-2007 was 65.2%; the observed IR was 22.6/100 000 and the estimated IR 31.3/10 000 (95%CI 25.0-37.7). CONCLUSION: The similarity of observed and estimated IR during the period 2010-2012 indicates the validity of the surveillance and the use of improved systems such as electronic medical records in recent years.

[Meningococcal disease. The situation in Spain in the 1998-1999 period]. / Enfermedad meningocócia. Situación en España en la temporada 1998-1999.

BACKGROUND: The change in the epidemiological pattern undergone by meningococcal disease in a large part of the country in the 1996-1997 season and the decision to intervene by means of a mass vaccination campaign in the age group between 18 months and 19 years of age, using a bivalent polysaccharide vaccine, justified to enhance the epidemiological surveillance of this disease. METHODS: Rates and other indicators of incidence and mortality were calculated for the 1998-1999 campaign by serogroup and age, according to the data notified to the Compulsory Disease Reporting System. RESULTS: The overall incidence was higher than the previous season, although, the rate ratio did not indicate a significantly greater risk. A statistically significant increase in the rate of incidence caused by serogroup B was registered, and for the second consecutive year, the serogroup C rate dropped, although not significantly. There was an increase in the number of deaths. The fatality rate due to serogroup C increased in the group between 1 and 4 years of age. The incidence remained high and with a clear seasonal pattern in the Communities that did not vaccinate. In the remainder, the incidence dropped and the seasonal pattern disappeared. CONCLUSIONS: Two years after the campaign, the predominance of serogroup B cases is generalised in all of the Autonomous Communities, except in the three where the immunisation was not performed. In the latter, in the course of the last two years, serogroup C has predominated. In the Communities where the vaccination campaign was carried out, there is an increase in the incidence, although not significantly, among children under 4 years of age.

[Meningococcal disease in Spain, 1990-1997. Change in its epidemiological pattern]. / La enfermedad meningocócica en España, 1990-1997. Cambio en su patrón epidemiológico.

BACKGROUND: In Spain, the presentation of meningococcal disease in the 1980s was closely linked to the predominance of N. Meningitidis serogroup B. This situation changed at the beginning of the 1990s, observing a growing trend of serogroup C strains in the isolation procedures carried out in some areas of the country, together with an increase in the incidence of the disease starting in the 1995-1996 season. The purpose of this study is to characterise the epidemiological pattern of meningococcal disease in Spain during the 1990-97 season and, in particular, where the disease was caused by the phenotype C:2b:P1.2.5 in this period of etiological change. METHODS: Retrospective study of the cases of meningococcal disease in Spain, with the exception of the Autonomous Communities of Andalusia, Cantabria, Madrid, Basque Country and Valencia, between 1990-1997. The epidemiological data were obtained from the Compulsory Disease Reporting system, through individualised notification of cases, and the microbiological data from the Meningococcus Reference Laboratory of the National Microbiology Centre. RESULTS: The incidence of meningococcal disease in the period studied, 1990-1997, was 3.81 x 10 - 6 person-years, increasing by 0.1851 cases per 100,000 inhabitants per year. Starting in 1995, the incidence caused by serogroup C practically tripled with respect to the preceding period, with a rate of incidence in 1997 of 2 cases per 100,000 inhabitants. This increase was to a large extent due to the emergence of the phenotype C:2b:P1.2,5, which in that same year registered an incidence of 1 case per 100,000 inhabitants. The increase in incidence affected all age groups, but was particularly significant in the 5-19 year-old group (annual rate of growth: 13.3%; P < 0.001). It was also found that there was an increase in the number of outbreaks reported and cases associated to them. The overall mortality rate was 7.7% (95% confidence interval: 7.0-8.4), and the mortality associated with the phenotype C:2b:P1.2.5 was significantly higher than that of the serogroup B chosen as reference (odds ratio: 1.69; 95% CI: 1.05-2.71), following adjustment for age, sex, clinical form and year. CONCLUSIONS: The pattern of meningococcal disease in the territory studied, during 1990-1997, was characterised by an increase in the incidence of serogroup C, particularly the emerging phenotype C:2b:P1.2,5. Together with this increase, a displacement of the incidence to higher age groups was observed, together with a tendency towards temporospatial aggregations of cases and an increase in the mortality associated with the new phenotype. This pattern is characteristic of epidemic situations of meningococcal disease caused by serogroup C.

[The association between regular alcohol consumption and accidents]. / Asociación entre el consumo habitual de alcohol y accidentes.

The traffic accidents prevention in the direction of attempting to limit drinking-driving behaviour is difficult to implement. However, if there was a relationship between these accidents and the regular consumption of alcohol, the reduction of alcohol use should be promoted. Likely, this strategy would be useful to other accidents. This study evaluates the association between regular consumption of alcohol and the occurrence of any type of accidents, a traffic accident, a home accident and an occupational accident. The information source has been interviews carried out to persons 16 years and older in National Health Interview Survey. In occupational accidents only interviews of men between 16 and 64 years of age have been used. The odds ratio (OR) calculated by logistic regression was the measure of association used. Except for home accidents, the results show statistically significant OR for the 16 to 24 and 25 to 44 age groups. For the occurrence of any type of accident, the ORs for the 16 to 24 years age group were: 1.37 for moderate drinkers, 1.87 for great drinkers and 2.55 for heavy drinkers, and the ORs for the 25 to 44 years age group were 1.28, 1.65 and 2.11 for the same levels of consumption. Similar magnitude of association showed the traffic and occupational accidents. In all cases interaction between regular consumption of alcohol and age was found. Our results suggest that a new direction in the health policy of accidents should be developed.