[Tuberculosis in the Bajo Deba area (Guipúzcoa, Spain) from 1995 to 2006].
BACKGROUND
Within the Multicenter Project on Tuberculosis Research performed in Spain in 1996-1997, the Bajo Deba Area reported the highest incidence of tuberculosis in the Basque Country. We analyzed the clinical and epidemiological characteristics of the tuberculosis population diagnosed in our area during the period of 1995 to 2006.


METHODS
Ambispective, observational study.


RESULTS
A total of 584 patients were diagnosed with tuberculosis. The disease affected the respiratory tract in 509 cases and other sites in 75 cases. The mean annual incidence rate of tuberculosis was 64.5 cases per 100 000 inhabitants (91.6 in 1995-1998; 34.9 in 2003-2006). The mean annual incidence rate of smear-positive patients was 20.7 cases per 100 000 inhabitants (33.8 in 1995-1998; 12.9 in 2003-2006). The 15 to 24-year-old group was the most highly affected during the period of 1995 to 1998 (mean annual incidence rate 199.4 cases per 100 000); in contrast, the > 75-year-old group was the most highly affected during the period of 2003 to 2006 (121.1 cases per 100 000 inhabitants). Fifty-three patients were co-infected by HIV (9%) (yearly mean of 11.6% in 1995-1998 and 7% in 2003-2006). Löwenstein culture was positive in 431 cases (73.8%). Resistance to isoniazid was detected in 1.4% out of a total of 287 strains tested, and multidrug resistance was not observed. Nine patients were immigrants (1.5%). Treatment completion was greater in our area (505 patients, 86.4%), as compared to that recorded in the Guipuzcoa province during the same period (1956 of 2525 patients, 77.5%) (P < .01).


CONCLUSIONS
The Bajo Deba Area presented a high incidence of tuberculosis in the 1995 to 2006 period. Epidemiological trends showed a progressive decrease in the number of tuberculosis patients, with a shift from younger to older persons as the most highly affected age group. The impact of drug resistance and immigration was negligible on tuberculosis rates. The percentage of microbiologically confirmed cases was high. Treatment completion was satisfactory.
García-Zamalloa
Alberto M
AM
Servicio de Medicina Interna, Hospital Comarcal de Mendaro, Guipúzcoa, España. alberto.garcia-zamalloazamalloa@osakidetza.net
Arrizabalaga
Julio
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*