[Effectiveness (accessibility and compliance) of a program of early diagnosis of pulmonary tuberculosis in a penitentiary population]. / Efectividad (accesibilidad y adherencia) de un programa de detección precoz de tuberculosis pulmonar en población reclusa.

The aim of the study was to determine the effectiveness of a pulmonary tuberculosis detection Program in a Spanish prison (280-320 inmates) with a high turn-over rate (500 entries annually). 754 prisoners without antituberculous chemotherapic or chemoprophylaxis were included. 642 (85.1%) had access to the Program; the highest percentage of access was obtained when tuberculin test was performed at the entrance (96.4%) versus 80.5% when it was differed (P < 0.000001). The compliance observed was 82.2%, with no evidence that a greater accessibility was influential al all. The effectiveness was 70%, greater when tuberculin test was performed at the entrance in prison (76.7%) versus 66.8% when it was differed (P < 0.000001). We conclude that since pulmonary tuberculosis rates in prisons are so high and since it is possible to obtain a high effectiveness in detection programs, if were generalize these programs in concurrence with an adequate treatment of tuberculosis cases we shall obtain high efficiency rates.

[Tuberculosis in León. An epidemiological approach]. / La tuberculosis en León. Aproximación epidemiológica.

The aim of the present study was an approach to the epidemiological status of tuberculosis in the León province. To this end, we studied the morbidity through the EDOs and we carried out two tuberculin surveys during 1988-1989 to assess RAI. The results showed infection prevalences of 1.19 and 1.09 at six years of age for the two study years, respectively, with a RAI between 0.118 and 0.079. We conclude that tuberculosis still is an important health problem. The RAI indicates that our level is that of a developed country. We also discuss the supposed increase in the frequency of tuberculosis.

[What epidemiological measures are useful in the evaluation of tuberculous disease?]. / "Qué medidas epidemiológicas son útiles en la valoración de la enfermedad tuberculosa?"

Among the epidemiological barometers useful in evaluating tuberculosis, the Annual Infection Risk is the one which has been shown to be the most useful. This rate can be calculated indirectly (by way of Tables) or directly (by testing the same group of individuals twice over a one-year period). The most ideal method for making these calculations, by consecutively having the same population of 6 year-olds at intervals over a one-year period, is presented. The results indicate a statistically significant difference (P less than 0.001) between the two methods, an indirect AIR of 0.079 to 0.118 being obtained, as related to a Case Rate of 0.44. The fact that said difference is probably due to the impact of the BCG vaccination, which leads to pressure phenomena, and finally, whilst we are not free of said vaccination, this index should be calculated indirectly, based on tuberculosis infection prevalence rates.