[Evaluation of a strategy for the control of tuberculosis in a health district of andalusia, Spain]. / Evaluación de una estrategia para el control de la tuberculosis en un distrito sanitario de Andalucía.

BACKGROUND: Tuberculosis in Spain and Andalusia, the incidence rates above those of surrounding countries. Many authors emphasize the need for improved epidemiological information, the organization of health services and social support to patients. The aim of this study was to evaluate the results obtained after developing a strategy involving the three elements outlined in the Primary Care District of Andalusia. METHODS: We followed up to 234 TB patients residing in the District and reported to the Epidemiological Surveillance System of Andalusia during the period 2004-2008. Were considered as indicators for evaluating the percentage of patients who completed treatment, the percentage of smear-positive contacts with study, new cases detected in the same and the incidence in children under 15 years. RESULTS: Of the 234 patients were followed up cash 95% of them completed treatment 182 (78%) died 18, moved from home, 10 and 12 still remained in treatment. Of the 130 cases that presented positive sputum studied 112 contacts (86%). 27 new cases were detected among the contacts studied, and the annual incidence in children under 15 years was 6.65 per 100,000 population. Tracking losses were reduced by 30%, and terminations of treatment and contact studies improved by 25% and 30% respectively compared to data from the whole of Andalusia. CONCLUSIONS: The strategy has helped improve the proposed assessment indicators. The% of new cases detected in studies of contacts and the annual incidence in children under 15 years was similar in this study than in Andalusia.

Evaluación de una estrategia para el control de la tuberculosis en un distrito sanitario de Andalucía / Evaluation of a strategy for the control of tuberculosis in a health district of Andalusia, Spain

Fundamento: La tuberculosis en España y Andalucía presenta tasas de incidencia por encima de las de países de nuestro entorno. Muchos autores señalan la necesidad de mejorar la información epidemiológica, la organización de los servicios sanitarios y el apoyo social a los pacientes. El objetivo de este trabajo es evaluar los resultados de una estrategia que contemplaba los tres elementos reseñados en un Distrito de Atención Primaria de Andalucía.Métodos: Se realizó el seguimiento a 234 enfermos de tuberculosis residentes en el Distrito y notificados al Sistema de Vigilancia Epidemiológica de Andalucía durante el período 2004-2008. Se consideraron como indicadores de evaluación el porcentaje que finalizó el tratamiento, el porcentaje de pacientes bacilíferos con estudio de contactos, los nuevos casos detectados en los mismos y la incidencia en menores de 15 años.Resultados:.De los 234 pacientes incluidos se realizó un seguimiento efectivo en el 95%, de ellos finalizaron el tratamiento 182 (78%), fallecieron 18, se trasladaron de domicilio 10 y continuaban aún en tratamiento12. De los 130 casos que presentaron baciloscopia positiva se estudiaron a los contactos de 112 (el 86%). Se detectaron 27 nuevos casos entre los contactos estudiados y la incidencia anual en menores de 15 años fue del 6.65 por 100.000. Las perdidas del seguimiento se redujeron un 30% y las finalizaciones del tratamiento y los estudios de contactos mejoraron un 25% y 30% respectivamente, respecto a los datos del conjunto de Andalucía.Conclusiones: La estrategia seguida ha permitido mejorar los indicadores de evaluación propuestos. El % de casos nuevos detectados en los estudios de contactos y la incidencia anual en menores de 15 años ha sido similar en este estudio que en Andalucía(AU)

Background: Tuberculosis in Spain and Andalusia, the incidence rates above those of surrounding countries. Many authors emphasize the need for improved epidemiological information, the organization of health services and social support to patients. The aim of this study was to evaluate the results obtained after developing a strategy involving the three elements outlined in the Primary Care District of Andalusia.Methods: We followed up to 234 TB patients residing in the District and reported to the Epidemiological Surveillance System of Andalusia during the period 2004-2008. Were considered as indicators for evaluating the percentage of patients who completed treatment, the percentage of smear-positive contacts with study, new cases detected in the same and the incidence in children under 15 years.Results:. Of the 234 patients were followed up cash 95% of them completed treatment 182 (78%) died 18, moved from home, 10 and 12 still remained in treatment. Of the 130 cases that presented positive sputum studied 112 contacts (86%). 27 new cases were detected among the contacts studied, and the annual incidence in children under 15 years was 6.65 per 100,000 population. Tracking losses were reduced by 30%, and terminations of treatment and contact studies improved by 25% and 30% respectively compared to data from the whole of Andalusia.Conclusions: The strategy has helped improve the proposed assessment indicators. The% of new cases detected in studies of contacts and the annual incidence in children under 15 years was similar in this study than in Andalusia(AU)