title: [Pulmonary tuberculosis and use of health services in zones of high socioeconomic marginalization in Chiapas, Mexico].
abstract: OBJECTIVE
  To estimate the prevalence of pulmonary tuberculosis and to analyze the utilization of health services, in coughers seeking care at primary care centers, within areas of "severe" and "very severe" poverty, in the Border Region of Chiapas, Mexico.
  
  
  METHODS
  In 1997 an active case finding of patients with cough was carried out among all patients aged over 14 years seeking consultation (n = 2.203) in a random sample of seven primary care centers; 573 coughers were found.
  
  
  RESULTS
  A rate of 11.1 positive pulmonary tuberculosis per hundred patients was found (95% CI = 6.6-17.2). The factors associated with positive pulmonary tuberculosis were size and poverty level of the locality of residence. Fifty-six percent of the coughers sought care for non-respiratory symptoms.
  
  
  CONCLUSIONS
  It is necessary to improve detection and control of pulmonary tuberculosis at the primary care centers, as well as to develop a health education campaign among the general population, with the aim of increasing the demands for care among coughers and reduce the time elapsed between onset of cough and first medical care.
authors.affiliation: División de Población y Salud, Colegio de la Frontera Sur, San Cristóbal de las Casas, Chiapas, México. hsanchez@sclc.ecosur.mx
authors.forename: H J
authors.initials: HJ
authors.lastname: Sánchez-Pérez
authors.forename: D
authors.initials: D
authors.lastname: Prat-Monterde
authors.forename: J M
authors.initials: JM
authors.lastname: Jansà
authors.forename: M
authors.initials: M
authors.lastname: Martín-Mateo
mesh_terms: D000328:Adult; D003371:Cough / Q000209:etiology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D011203:Poverty; D012959:Socioeconomic Factors; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*