[Evaluation of an applied program for the prevention and control of tuberculosis].
BACKGROUND
To evaluate the efficacy of a tuberculosis prevention and control program applied in the health care area of Cadiz (Spain).


METHODS
Tuberculosis cases diagnosed by microbiological criteria (Ziehl-Neelsen/auramine smear and/or culture in Löwenstein-Jensen medium) from 1996 to 2000 were analyzed in relation to epidemiologic characteristics of the patients. Susceptibility studies were performed from 1997 onwards using the proportion method described by Canetti, Rist and Grosset.


RESULTS
The rate of tuberculous infections gradually dropped from 38.4 cases/100,000 inhabitants in 1996 to 16.0 cases/100,000 inhabitants in 2000. Along the study period, the percentage of men affected by the disease ranged from 81.2% in 1996 to 70.0% in 2000. In 1996, 26.0% of tuberculous patients were HIV-positive, and in 2000, 27.5%. The sensitivity of microbiologic diagnosis increased considerably from 60.4% in 1996 to 67.5% in 2000. Multi-drug resistance (9.2% en 1997) has virtually disappeared in our area since 1998 (1.6%).CONCLUSIONS. Implementation of a plan for the prevention and control of tuberculosis in our geographic area was effective, resulting in a decrease in the infection rate to less than 25 cases/100,000 inhabitants, and improvements in microbiologic diagnosis and compliance with treatment. Tuberculous disease has affected an increasingly higher proportion of women, regardless of HIV status. Antimicrobial resistance, particularly multi-drug resistance is now low in our area.
Puerto Alonso
José Luis
JL
Servicio de Microbiología, Hospital Universitario Puerta del Mar, Cádiz, Spain.
García-Martos
Pedro
P
Marín Casanova
Pilar
P
Saldarreaga Marín
Abel
A
Vega Elías
Javier de la
Jde L
Mira Gutiérrez
José
J
D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D001431:Bacteriological Techniques; D015897:Comorbidity; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006266:Health Education / Q000458:organization & administration; D006282:Health Personnel / Q000193:education; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods / Q000458:organization & administration*; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D011159:Population Surveillance; D015397:Program Evaluation; D012042:Registries / Q000706:statistics & numerical data; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology
D000995:Antitubercular Agents