array:23 [
  "pii" => "S1579212906603558"
  "issn" => "15792129"
  "doi" => "10.1016/S1579-2129(06)60355-8"
  "estado" => "S300"
  "fechaPublicacion" => "2004-10-01"
  "aid" => "60355"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
  "copyrightAnyo" => "2004"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 2004;40:453-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2224
    "formatos" => array:3 [
      "EPUB" => 92
      "HTML" => 1538
      "PDF" => 594
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S157921290660356X"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60356-X"
    "estado" => "S300"
    "fechaPublicacion" => "2004-10-01"
    "aid" => "60356"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2004;40:459-62"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 6247
      "formatos" => array:3 [
        "EPUB" => 103
        "HTML" => 3408
        "PDF" => 2736
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
      "titulo" => "Altitude&#44; the Ratio of PaO<span class="elsevierStyleInf">2</span> to Fraction of Inspired Oxygen&#44; and Shunt&#58; Impact on the Assessment of Acute Lung Injury"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "459"
          "paginaFinal" => "462"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;R&#46; P&#233;rez-Padilla"
          "autores" => array:1 [
            0 => array:3 [
              "preGrado" => "Dr&#46;"
              "nombre" => "J&#46;R&#46;"
              "apellidos" => "P&#233;rez-Padilla"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921290660356X?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004000000010/v1_201305141820/S157921290660356X/v1_201305141820/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1579212906603546"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60354-6"
    "estado" => "S300"
    "fechaPublicacion" => "2004-10-01"
    "aid" => "60354"
    "copyright" => "Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2004;40:449-52"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2103
      "formatos" => array:3 [
        "EPUB" => 103
        "HTML" => 1302
        "PDF" => 698
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
      "titulo" => "Human Leukocyte Antigens A and B in Turkish Patients With Sarcoidosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "449"
          "paginaFinal" => "452"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "G&#46; &#199;elik, E&#46; &#350;en, A&#46;F&#46; &#220;lger, &#214;&#46; &#214;zdemir-Kumbasar, D&#46; Alper, A&#46;H&#46; Elhan, H&#46; Tutkak, A&#46; &#199;etiny&#252;rek"
          "autores" => array:8 [
            0 => array:3 [
              "preGrado" => "Prof"
              "nombre" => "G&#46;"
              "apellidos" => "&#199;elik"
            ]
            1 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "&#350;en"
            ]
            2 => array:2 [
              "nombre" => "A&#46;F&#46;"
              "apellidos" => "&#220;lger"
            ]
            3 => array:2 [
              "nombre" => "&#214;&#46;"
              "apellidos" => "&#214;zdemir-Kumbasar"
            ]
            4 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Alper"
            ]
            5 => array:2 [
              "nombre" => "A&#46;H&#46;"
              "apellidos" => "Elhan"
            ]
            6 => array:2 [
              "nombre" => "H&#46;"
              "apellidos" => "Tutkak"
            ]
            7 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "&#199;etiny&#252;rek"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603546?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004000000010/v1_201305141820/S1579212906603546/v1_201305141820/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
    "titulo" => "Active Tuberculosis Case Finding Among Immigrants in Barcelona"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "453"
        "paginaFinal" => "458"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "J&#46; Alcaide Meg&#237;as, M&#46;N&#46; Altet G&#243;mez, M&#46;L&#46; de Souza Galvao, M&#46;A&#46; Jim&#233;nez Fuentes, C&#46; Mil&#224; Auge, J&#46; Solsona Peir&#243;"
        "autores" => array:6 [
          0 => array:5 [
            "preGrado" => "Dr&#46;"
            "nombre" => "J&#46;"
            "apellidos" => "Alcaide Meg&#237;as"
            "email" => array:1 [
              0 => "4862jam&#64;comb&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "M&#46;N&#46;"
            "apellidos" => "Altet G&#243;mez"
          ]
          2 => array:2 [
            "nombre" => "M&#46;L&#46;"
            "apellidos" => "de Souza Galvao"
          ]
          3 => array:2 [
            "nombre" => "M&#46;A&#46;"
            "apellidos" => "Jim&#233;nez Fuentes"
          ]
          4 => array:2 [
            "nombre" => "C&#46;"
            "apellidos" => "Mil&#224; Auge"
          ]
          5 => array:2 [
            "nombre" => "J&#46;"
            "apellidos" => "Solsona Peir&#243;"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Centro de Prevenci&#243;n y Control de la Tuberculosis&#44; CAP Drassanes&#44; Institut Catal&#224; de la Salut&#44; Barcelona&#44; Spain"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Correspondence&#58; Dr&#46; J&#46; Alcaide Meg&#237;as&#46; CAP Drassanes&#46; Avda&#46; Drassanes&#44; 17-19&#46; 08001 Barcelona&#46; Espa&#241;a"
          ]
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2003-10-08"
    "fechaAceptado" => "2004-04-13"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key Words"
          "identificador" => "xpalclavsec153134"
          "palabras" => array:3 [
            0 => "Tuberculosis and immigration"
            1 => "Epidemiology"
            2 => "Tuberculin test"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec153135"
          "palabras" => array:3 [
            0 => "Tuberculosis e inmigraci&#243;n"
            1 => "Epidemiolog&#237;a"
            2 => "Prueba de la tuberculina"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO assess the prevalence of tuberculous infection and disease in recent economic immigrants in Barcelona&#46;</p> <span class="elsevierStyleSectionTitle">Subjects And Method</span><p class="elsevierStyleSimplePara elsevierViewall">Examination and testing of immigrants&#46; Tuberculin tests &#40;TTs&#41; were given and the presence of scars from tuberculosis vaccinations were noted&#46; Thresholds of 5 and 15 mm were established for positivity in unvaccinated and vaccinated individuals&#44; respectively&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 3651 persons were examined&#44; but only 3151 completed the study&#46; Eighteen were diagnosed with tuberculosis &#40;571&#46;2 per 100&#8200;000&#41; and 50&#46;6&#37; were classified as positive TT reactors&#44; 34&#46;4&#37; because of infection and 16&#46;3&#37; possibly because of tuberculosis vaccination&#46; The percentage of reactors was significantly higher in the sample of economic immigrants than in the local population&#46; Age&#44; male sex&#44; place of origin&#44; greater poverty&#44; and higher prevalence of disease in the country of origin were associated with tuberculous infection in the sample&#46;</p> <span class="elsevierStyleSectionTitle">Discussion</span><p class="elsevierStyleSimplePara elsevierViewall">Active case finding proved efficient&#46; Interference from tuberculosis vaccination greatly affects TT findings&#44; depending on the positivity threshold that is established&#46; We recommend that chest radiographs be used in addition to TTs&#46; Immigration will change the nature of endemic tuberculosis in Spain&#44; and strategies should be specifically designed to deal with the new challenges that will appear&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer la prevalencia de la infecci&#243;n y de la enfermedad tuberculosa en inmigrantes econ&#243;micos y recientes en Barcelona&#46;</p> <span class="elsevierStyleSectionTitle">Sujetos Y M&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Reconocimiento m&#233;dico de inmigrantes&#46; Se practic&#243; la prueba de tuberculina &#40;PT&#41; y se indag&#243; la presencia de cicatriz posvacunaci&#243;n antituberculosa&#46; Se estableci&#243; el dintel de positividad de la PT en 5 mm para los no vacunados y en 15 mm para los vacunados&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se examin&#243; a 3&#46;651 personas&#44; pero s&#243;lo se incluy&#243; en el an&#225;lisis a las 3&#46;151 que completaron el estudio&#46; Se diagnostic&#243; a 18 enfermos &#40;tasa de 571&#44;2 por 100&#46;000&#41; y el 50&#44;6&#37; se catalog&#243; como reactores positivos a la PT&#44; siendo el 34&#44;4&#37; reactores por infecci&#243;n y 16&#44;3&#37; por posible vacunaci&#243;n antituberculosa&#46; El porcentaje de reactores es estad&#237;sti-camente superior al encontrado en una poblaci&#243;n aut&#243;ctona&#46; La edad&#44; ser var&#243;n&#44; la regi&#243;n de procedencia&#44; la mayor po-breza y la mayor tasa de enfermedad en el pa&#237;s de origen se mostraron asociados a la prevalencia de la infecci&#243;n tuberculosa de los inmigrantes&#46;</p> <span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">La b&#250;squeda activa se ha mostrado eficiente&#46; La interferencia de la vacunaci&#243;n antituberculosa modifica mucho los resultados&#44; seg&#250;n el dintel de positividad de la PT que se establezca&#46; Se recomienda realizar la PT junto con la radiolog&#237;a del t&#243;rax&#46; La inmigraci&#243;n modificar&#225; la endemia tuberculosa del pa&#237;s y se han de dise&#241;ar estrategias espec&#237;fi-cas para afrontar este nuevo reto de la tuberculosis&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:39 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "JA Caminero Luna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "Gu&#237;a de la tuberculosis para m&#233;dicos especialistas"
                        "fecha" => "2003"
                        "editorial" => "UICTER"
                        "editorialLocalizacion" => "Par&#237;s"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enfermedades emergentes&#46; Alerta mundial&#46; Respuesta Mundial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "JJ Gestal Otero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud P&#250;blica"
                        "fecha" => "1997"
                        "volumen" => "71"
                        "paginaInicial" => "225"
                        "paginaFinal" => "230"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9445750"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "HL Rieder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "Bases epidemiol&#243;gicas del control de la tuberculosis"
                        "fecha" => "1999"
                        "editorial" => "UICTER"
                        "editorialLocalizacion" => "Par&#237;s"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis y migraciones internacionales"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P Chaulet"
                            1 => "R Ferlinz"
                            2 => "JP Zellweger"
                            3 => "R Vejdovsky"
                            4 => "P Eriki"
                            5 => "HA van Geuns"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Bol Uni&#243;n Int Tuber Enf Respir"
                        "fecha" => "1988"
                        "volumen" => "63"
                        "paginaInicial" => "28"
                        "paginaFinal" => "36"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "WHO Report 2002"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:3 [
                        "titulo" => "Global tuberculosis control&#58; surveillance&#44; planning&#44; financing"
                        "paginaInicial" => "295"
                        "serieFecha" => "2002"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inmigraci&#243;n y tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F S&#225;nchez Gasc&#243;n"
                            1 => "R Bernabeu Mesa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2003"
                        "volumen" => "39"
                        "paginaInicial" => "5"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12550012"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations of WHO&#44; IUATLD and KNCV Working Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "European Framework for Tuberculosis Control and Elimination in Countries With a Low Incidence"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2002"
                        "volumen" => "19"
                        "paginaInicial" => "765"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11999007"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Programa de Prevenci&#243; i Control de la Tuberculosi de Catalunya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "Memoria any 2002"
                        "fecha" => "2003"
                        "editorial" => "Departament de Sanitat i Seguretat Social"
                        "editorialLocalizacion" => "Barcelona"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inmigraci&#243;n extranjera en el estado espa&#241;ol&#46; Consideraciones desde la salud p&#250;blica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "JM Jans&#224;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud P&#250;blica"
                        "fecha" => "1998"
                        "volumen" => "72"
                        "paginaInicial" => "165"
                        "paginaFinal" => "168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9810823"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis importada&#58; una enfermedad emergente en pa&#237;ses industrializados"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "X Vall&#232;s"
                            1 => "F S&#225;nchez"
                            2 => "H Pa&#241;ella"
                            3 => "P Garc&#237;a Olalla"
                            4 => "JM Jans&#224;"
                            5 => "JA Cayl&#224;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2002"
                        "volumen" => "1 18"
                        "paginaInicial" => "376"
                        "paginaFinal" => "378"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis e inmigraci&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J Ruiz Manzano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2000"
                        "volumen" => "1 14"
                        "paginaInicial" => "257"
                        "paginaFinal" => "258"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis en inmigrantes reci&#233;n llegados a Barcelona"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E Dur&#225;n"
                            1 => "J Cabezas"
                            2 => "M Ros"
                            3 => "M Terre"
                            4 => "F Zarzuela"
                            5 => "JL Bada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1996"
                        "volumen" => "106"
                        "paginaInicial" => "525"
                        "paginaFinal" => "528"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La inmigraci&#243;n en Canarias y su posible influencia sobre el problema de la tuberculosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "JA Caminero"
                            1 => "F Rodr&#237;guez"
                            2 => "J Cuy&#225;s"
                            3 => "P Cabrera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2001"
                        "volumen" => "1 16"
                        "paginaInicial" => "556"
                        "paginaFinal" => "557"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consenso Nacional para el control de la tuberculosis en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Grupo de trabajo sobre Tuberculosis"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1992"
                        "volumen" => "98"
                        "paginaInicial" => "24"
                        "paginaFinal" => "31"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagn&#243;stico de la tuberculosis &#40;Normativas SEPAR&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Grupo de trabajo sobre Tuberculosis de la SEPAR"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "1996"
                        "volumen" => "32"
                        "paginaInicial" => "85"
                        "paginaFinal" => "99"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8948872"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de la infecci&#243;n tuberculosa en adultos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J Alcaide"
                            1 => "MN Altet"
                            2 => "J Canela-Soler"
                            3 => "JM Pina"
                            4 => "C Mil&#224;"
                            5 => "ML de Souza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2003"
                        "volumen" => "203"
                        "paginaInicial" => "321"
                        "paginaFinal" => "328"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12797913"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "World development indicators&#44; 2003"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "The World Bank Group"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "WWW" => array:1 [
                        "link" => "Available at&#58; http&#58;&#47;&#47;www&#46;vorldbank&#46;org"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Situaci&#243;n actual de la tuberculosis en Espa&#241;a&#46; Una perspectiva en precario respecto a los pa&#237;ses desarrollados"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R Rey"
                            1 => "V Ausina"
                            2 => "M Casal"
                            3 => "JA Cayl&#224;"
                            4 => "P de March"
                            5 => "S Moreno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1995"
                        "volumen" => "105"
                        "paginaInicial" => "703"
                        "paginaFinal" => "707"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Longitudinal incidence of tuberculosis in South-East Asian refugees after re-settlement"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "CR Maclntyre"
                            1 => "AJ Plant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Tuberc Lung Dis"
                        "fecha" => "1999"
                        "volumen" => "3"
                        "paginaInicial" => "287"
                        "paginaFinal" => "299"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10206498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening for tuberculosis and latent tuberculosis infection among undocumented immigrants at on unspecialised health service unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I el-Hamad"
                            1 => "C Casolini"
                            2 => "A Matteelli"
                            3 => "S Casari"
                            4 => "M Bugiani"
                            5 => "M Caputo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Tuberc Lung Dis"
                        "fecha" => "2001"
                        "volumen" => "5"
                        "paginaInicial" => "712"
                        "paginaFinal" => "716"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of tuberculosis in a community of Senegalese immigrants in Northern Italy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C Scalori"
                            1 => "I el-Hamad"
                            2 => "A Mateelli"
                            3 => "E Bombana"
                            4 => "R Maioli"
                            5 => "C de Leonardis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Tuberc Lung Dis"
                        "fecha" => "1999"
                        "volumen" => "3"
                        "paginaInicial" => "18"
                        "paginaFinal" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10094165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controlling tuberculosis among foreign born within industrialized countries&#46; Expensive band-aids"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D Menzies"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.164.6.2107090b"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "164"
                        "paginaInicial" => "914"
                        "paginaFinal" => "915"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11587969"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enfermedades infecciosas y caracter&#237;sticas sociodemogr&#225;ficas de los inmigrantes extranjeros del centro penitenciario de hombres de Barcelona"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J Garc&#237;a Vidal"
                            1 => "JM Jans&#224; L&#243;pez del Vallado"
                            2 => "P Garc&#237;a de Olalla Rizo"
                            3 => "I Barn&#233;s Vay&#233;s"
                            4 => "JA Cayl&#224; Busqueras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud P&#250;blica"
                        "fecha" => "1998"
                        "volumen" => "72"
                        "paginaInicial" => "197"
                        "paginaFinal" => "208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9810827"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis notification in England&#58; the relative effects of deprivation and immigration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K Tacque"
                            1 => "MJ Doherty"
                            2 => "MA Bellis"
                            3 => "DPS Spence"
                            4 => "CSD Willians"
                            5 => "PDO Daveis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Tuberc Lung Dis"
                        "fecha" => "1998"
                        "volumen" => "2"
                        "paginaInicial" => "213"
                        "paginaFinal" => "218"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9526193"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inmigraci&#243;n africana en Canarias e infecci&#243;n tuberculosa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "JL P&#233;rez Arellano"
                            1 => "A Hern&#225;ndez Garc&#237;a"
                            2 => "O Sanz Pel&#225;ez"
                            3 => "AA Moreno Maroto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2002"
                        "volumen" => "118"
                        "paginaInicial" => "38"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interferencias de la campa&#241;a de vacunaci&#243;n B CG en Espa&#241;a con los cribados actuales con la prueba de tuberculina"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J Alcaide"
                            1 => "MN Altet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Vacunas"
                        "fecha" => "2002"
                        "volumen" => "3"
                        "paginaInicial" => "54"
                        "paginaFinal" => "59"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transmission of tuberculosis in San Francisco and its association with immigration and ethnicity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "MW Borgdorff"
                            1 => "MA Behr"
                            2 => "NJD Nopelkerke"
                            3 => "PC Hopewell"
                            4 => "PM Small"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Tuberc Lung Dis"
                        "fecha" => "2000"
                        "volumen" => "4"
                        "paginaInicial" => "287"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10777075"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis in Mexican-born persons in San Francisco&#58; reactivation&#44; acquired infection and transmission"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "RM Jasner"
                            1 => "A Ponce de Le&#243;n"
                            2 => "PC Hopewell"
                            3 => "RG Alarc&#243;n"
                            4 => "AR Mas"
                            5 => "E Antonio Paz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Tuberc Lung Dis"
                        "fecha" => "1997"
                        "volumen" => "1"
                        "paginaInicial" => "536"
                        "paginaFinal" => "541"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9487452"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio del retraso diagn&#243;stico de la tuberculosis pulmonar sintom&#225;tica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "MN Altet G&#243;mez"
                            1 => "J Alcaide Meg&#237;as"
                            2 => "J Canela Soler"
                            3 => "C Mil&#224; Aug&#233;"
                            4 => "MA Jim&#233;nez Fuentes"
                            5 => "ML de Souza Galvao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2003"
                        "volumen" => "39"
                        "paginaInicial" => "146"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12716554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis among foreign-born persons in New York City&#44; 1992-1994&#58; implications for tuberculosis control"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "NG Torniepart"
                            1 => "J Ptachewich"
                            2 => "N Paltoratskia"
                            3 => "BS Rovi"
                            4 => "M Katapodi"
                            5 => "JJ Berger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Tuberc Lung Dis"
                        "fecha" => "1997"
                        "volumen" => "1"
                        "paginaInicial" => "528"
                        "paginaFinal" => "535"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9487451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enfermedades importadas en inmigrantes africanos&#58; estudiode 1&#46;321 pacientes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C Roca"
                            1 => "X Balanz&#243;"
                            2 => "JL Fern&#225;ndez-Roure"
                            3 => "G Sauca"
                            4 => "R Savall"
                            5 => "J Gasc&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2002"
                        "volumen" => "1 19"
                        "paginaInicial" => "616"
                        "paginaFinal" => "619"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of tuberculosis among a cohort of tuberculin-positive refugees in Australia&#46; Reappraising the estimates of risk"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "GB Marks"
                            1 => "J Bai"
                            2 => "SE Simpson"
                            3 => "EA Sullivan"
                            4 => "GJ Stewart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.162.5.2004154"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "162"
                        "paginaInicial" => "1851"
                        "paginaFinal" => "1854"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11069825"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis en inmigrantes reci&#233;n llegados a Barcelona"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E Dur&#225;n"
                            1 => "J Cabezos"
                            2 => "M Ros"
                            3 => "M Terre"
                            4 => "F Zarzuela"
                            5 => "JL Bada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1996"
                        "volumen" => "106"
                        "paginaInicial" => "525"
                        "paginaFinal" => "528"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia de infecci&#243;n tuberculosa en la poblaci&#243;n de inmigrantes en Ceuta&#44; Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "MT Fern&#225;ndez Sanfrancisco"
                            1 => "J D&#237;az Portillo"
                            2 => "JM S&#225;nchez Romero"
                            3 => "A P&#233;rez Fern&#225;ndez"
                            4 => "J Vadillo Andrade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Salud P&#250;blica"
                        "fecha" => "2001"
                        "volumen" => "75"
                        "paginaInicial" => "551"
                        "paginaFinal" => "558"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11833264"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia de tuberculosis en una poblaci&#243;n procedente de Kosovo acogida en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I Casas Garc&#237;a"
                            1 => "J Ruiz Manzano"
                            2 => "A Carreras Molas"
                            3 => "A Segura Egea"
                            4 => "M Esteve Pardo"
                            5 => "X Casas Garc&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2001"
                        "volumen" => "1 16"
                        "paginaInicial" => "770"
                        "paginaFinal" => "771"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tuberculosis en la poblaci&#243;n inmigrantes de Bilbao"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C Salinas Solano"
                            1 => "L Altube Urrengoetsea"
                            2 => "PP Espa&#241;a Yandiola"
                            3 => "A Capalastegui S&#225;ez"
                            4 => "JM Quintana L&#243;pez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2002"
                        "volumen" => "38"
                        "paginaInicial" => "506"
                        "paginaFinal" => "510"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12435315"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La prueba de la tuberculina en los vacunados con BCG"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P Miret Cuadras"
                            1 => "JM Pina Guti&#233;rrez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "1998"
                        "volumen" => "34"
                        "paginaInicial" => "421"
                        "paginaFinal" => "424"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9842453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia de la infecci&#243;n tuberculosa entre los inmigrantes magreb&#237;es"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "FPJ Rivas Clemente"
                            1 => "N N&#225;cher Conches"
                            2 => "J Corrillero-Mart&#237;n"
                            3 => "MT Garc&#237;a-Herreros Madue&#241;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2000"
                        "volumen" => "1 14"
                        "paginaInicial" => "245"
                        "paginaFinal" => "249"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resultados de un programa de b&#250;squeda activa de tuberculosis en inmigrantes magreb&#237;es&#58; aceptabilidad y adhesi&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "FPJ Rivas Clemente"
                            1 => "N N&#225;cher Conches"
                            2 => "J Corrillero-Mart&#237;n"
                            3 => "S V&#233;lez-Reyes"
                            4 => "L Huerta-Galindo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "1999"
                        "volumen" => "24"
                        "paginaInicial" => "411"
                        "paginaFinal" => "416"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10592549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000004000000010/v1_201305141820/S1579212906603558/v1_201305141820/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004000000010/v1_201305141820/S1579212906603558/v1_201305141820/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603558?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 40. Issue 10.
Pages 453-458 (October 2004)
Share
Share
Download PDF
More article options
Vol. 40. Issue 10.
Pages 453-458 (October 2004)
Original Articles
Full text access
Active Tuberculosis Case Finding Among Immigrants in Barcelona
Visits
4121
J. Alcaide Megías
Corresponding author
4862jam@comb.es

Correspondence: Dr. J. Alcaide Megías. CAP Drassanes. Avda. Drassanes, 17-19. 08001 Barcelona. España
, M.N. Altet Gómez, M.L. de Souza Galvao, M.A. Jiménez Fuentes, C. Milà Auge, J. Solsona Peiró
Centro de Prevención y Control de la Tuberculosis, CAP Drassanes, Institut Català de la Salut, Barcelona, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Objective

TO assess the prevalence of tuberculous infection and disease in recent economic immigrants in Barcelona.

Subjects And Method

Examination and testing of immigrants. Tuberculin tests (TTs) were given and the presence of scars from tuberculosis vaccinations were noted. Thresholds of 5 and 15 mm were established for positivity in unvaccinated and vaccinated individuals, respectively.

Results

A total of 3651 persons were examined, but only 3151 completed the study. Eighteen were diagnosed with tuberculosis (571.2 per 100 000) and 50.6% were classified as positive TT reactors, 34.4% because of infection and 16.3% possibly because of tuberculosis vaccination. The percentage of reactors was significantly higher in the sample of economic immigrants than in the local population. Age, male sex, place of origin, greater poverty, and higher prevalence of disease in the country of origin were associated with tuberculous infection in the sample.

Discussion

Active case finding proved efficient. Interference from tuberculosis vaccination greatly affects TT findings, depending on the positivity threshold that is established. We recommend that chest radiographs be used in addition to TTs. Immigration will change the nature of endemic tuberculosis in Spain, and strategies should be specifically designed to deal with the new challenges that will appear.

Key Words:
Tuberculosis and immigration
Epidemiology
Tuberculin test
Objetivo

Conocer la prevalencia de la infección y de la enfermedad tuberculosa en inmigrantes económicos y recientes en Barcelona.

Sujetos Y Método

Reconocimiento médico de inmigrantes. Se practicó la prueba de tuberculina (PT) y se indagó la presencia de cicatriz posvacunación antituberculosa. Se estableció el dintel de positividad de la PT en 5 mm para los no vacunados y en 15 mm para los vacunados.

Resultados

Se examinó a 3.651 personas, pero sólo se incluyó en el análisis a las 3.151 que completaron el estudio. Se diagnosticó a 18 enfermos (tasa de 571,2 por 100.000) y el 50,6% se catalogó como reactores positivos a la PT, siendo el 34,4% reactores por infección y 16,3% por posible vacunación antituberculosa. El porcentaje de reactores es estadísti-camente superior al encontrado en una población autóctona. La edad, ser varón, la región de procedencia, la mayor po-breza y la mayor tasa de enfermedad en el país de origen se mostraron asociados a la prevalencia de la infección tuberculosa de los inmigrantes.

Discusión

La búsqueda activa se ha mostrado eficiente. La interferencia de la vacunación antituberculosa modifica mucho los resultados, según el dintel de positividad de la PT que se establezca. Se recomienda realizar la PT junto con la radiología del tórax. La inmigración modificará la endemia tuberculosa del país y se han de diseñar estrategias específi-cas para afrontar este nuevo reto de la tuberculosis.

Palabras clave:
Tuberculosis e inmigración
Epidemiología
Prueba de la tuberculina
Full text is only aviable in PDF
REFERENCES
[1]
JA Caminero Luna.
Guía de la tuberculosis para médicos especialistas, UICTER, (2003),
[2]
JJ Gestal Otero.
Enfermedades emergentes. Alerta mundial. Respuesta Mundial.
Rev Esp Salud Pública, 71 (1997), pp. 225-230
[3]
HL Rieder.
Bases epidemiológicas del control de la tuberculosis, UICTER, (1999),
[4]
P Chaulet, R Ferlinz, JP Zellweger, R Vejdovsky, P Eriki, HA van Geuns.
Tuberculosis y migraciones internacionales.
Bol Unión Int Tuber Enf Respir, 63 (1988), pp. 28-36
[5]
WHO Report 2002.
Global tuberculosis control: surveillance, planning, financing, pp. 295
[6]
F Sánchez Gascón, R Bernabeu Mesa.
Inmigración y tuberculosis.
Arch Bronconeumol, 39 (2003), pp. 5-7
[7]
European Framework for Tuberculosis Control and Elimination in Countries With a Low Incidence.
Recommendations of WHO, IUATLD and KNCV Working Group.
Eur Respir J, 19 (2002), pp. 765-775
[8]
Programa de Prevenció i Control de la Tuberculosi de Catalunya.
Memoria any 2002, Departament de Sanitat i Seguretat Social, (2003),
[9]
JM Jansà.
Inmigración extranjera en el estado español. Consideraciones desde la salud pública.
Rev Esp Salud Pública, 72 (1998), pp. 165-168
[10]
X Vallès, F Sánchez, H Pañella, P García Olalla, JM Jansà, JA Caylà.
Tuberculosis importada: una enfermedad emergente en países industrializados.
Med Clin (Barc), 1 18 (2002), pp. 376-378
[11]
J Ruiz Manzano.
Tuberculosis e inmigración.
Med Clin (Barc), 1 14 (2000), pp. 257-258
[12]
E Durán, J Cabezas, M Ros, M Terre, F Zarzuela, JL Bada.
Tuberculosis en inmigrantes recién llegados a Barcelona.
Med Clin (Barc), 106 (1996), pp. 525-528
[13]
JA Caminero, F Rodríguez, J Cuyás, P Cabrera.
La inmigración en Canarias y su posible influencia sobre el problema de la tuberculosis.
Med Clin (Barc), 1 16 (2001), pp. 556-557
[14]
Grupo de trabajo sobre Tuberculosis.
Consenso Nacional para el control de la tuberculosis en España.
Med Clin (Barc), 98 (1992), pp. 24-31
[15]
Grupo de trabajo sobre Tuberculosis de la SEPAR.
Diagnóstico de la tuberculosis (Normativas SEPAR).
Arch Bronconeumol, 32 (1996), pp. 85-99
[16]
J Alcaide, MN Altet, J Canela-Soler, JM Pina, C Milà, ML de Souza, et al.
Estudio de la infección tuberculosa en adultos.
Rev Clin Esp, 203 (2003), pp. 321-328
[17]
The World Bank Group.
World development indicators, 2003.
[18]
R Rey, V Ausina, M Casal, JA Caylà, P de March, S Moreno, et al.
Situación actual de la tuberculosis en España. Una perspectiva en precario respecto a los países desarrollados.
Med Clin (Barc), 105 (1995), pp. 703-707
[19]
CR Maclntyre, AJ Plant.
Longitudinal incidence of tuberculosis in South-East Asian refugees after re-settlement.
Int J Tuberc Lung Dis, 3 (1999), pp. 287-299
[20]
I el-Hamad, C Casolini, A Matteelli, S Casari, M Bugiani, M Caputo, et al.
Screening for tuberculosis and latent tuberculosis infection among undocumented immigrants at on unspecialised health service unit.
Int J Tuberc Lung Dis, 5 (2001), pp. 712-716
[21]
C Scalori, I el-Hamad, A Mateelli, E Bombana, R Maioli, C de Leonardis, et al.
Incidence of tuberculosis in a community of Senegalese immigrants in Northern Italy.
Int J Tuberc Lung Dis, 3 (1999), pp. 18-22
[22]
D Menzies.
Controlling tuberculosis among foreign born within industrialized countries. Expensive band-aids.
Am J Respir Crit Care Med, 164 (2001), pp. 914-915
[23]
J García Vidal, JM Jansà López del Vallado, P García de Olalla Rizo, I Barnés Vayés, JA Caylà Busqueras.
Enfermedades infecciosas y características sociodemográficas de los inmigrantes extranjeros del centro penitenciario de hombres de Barcelona.
Rev Esp Salud Pública, 72 (1998), pp. 197-208
[24]
K Tacque, MJ Doherty, MA Bellis, DPS Spence, CSD Willians, PDO Daveis.
Tuberculosis notification in England: the relative effects of deprivation and immigration.
Int J Tuberc Lung Dis, 2 (1998), pp. 213-218
[25]
JL Pérez Arellano, A Hernández García, O Sanz Peláez, AA Moreno Maroto.
Inmigración africana en Canarias e infección tuberculosa.
Med Clin (Barc), 118 (2002), pp. 38
[26]
J Alcaide, MN Altet.
Interferencias de la campaña de vacunación B CG en España con los cribados actuales con la prueba de tuberculina.
Vacunas, 3 (2002), pp. 54-59
[27]
MW Borgdorff, MA Behr, NJD Nopelkerke, PC Hopewell, PM Small.
Transmission of tuberculosis in San Francisco and its association with immigration and ethnicity.
Int J Tuberc Lung Dis, 4 (2000), pp. 287-294
[28]
RM Jasner, A Ponce de León, PC Hopewell, RG Alarcón, AR Mas, E Antonio Paz, et al.
Tuberculosis in Mexican-born persons in San Francisco: reactivation, acquired infection and transmission.
Int J Tuberc Lung Dis, 1 (1997), pp. 536-541
[29]
MN Altet Gómez, J Alcaide Megías, J Canela Soler, C Milà Augé, MA Jiménez Fuentes, ML de Souza Galvao, et al.
Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática.
Arch Bronconeumol, 39 (2003), pp. 146-152
[30]
NG Torniepart, J Ptachewich, N Paltoratskia, BS Rovi, M Katapodi, JJ Berger, et al.
Tuberculosis among foreign-born persons in New York City, 1992-1994: implications for tuberculosis control.
Int J Tuberc Lung Dis, 1 (1997), pp. 528-535
[31]
C Roca, X Balanzó, JL Fernández-Roure, G Sauca, R Savall, J Gascón, et al.
Enfermedades importadas en inmigrantes africanos: estudiode 1.321 pacientes.
Med Clin (Barc), 1 19 (2002), pp. 616-619
[32]
GB Marks, J Bai, SE Simpson, EA Sullivan, GJ Stewart.
Incidence of tuberculosis among a cohort of tuberculin-positive refugees in Australia. Reappraising the estimates of risk.
Am J Respir Crit Care Med, 162 (2000), pp. 1851-1854
[33]
E Durán, J Cabezos, M Ros, M Terre, F Zarzuela, JL Bada.
Tuberculosis en inmigrantes recién llegados a Barcelona.
Med Clin (Barc), 106 (1996), pp. 525-528
[34]
MT Fernández Sanfrancisco, J Díaz Portillo, JM Sánchez Romero, A Pérez Fernández, J Vadillo Andrade.
Prevalencia de infección tuberculosa en la población de inmigrantes en Ceuta, España.
Rev Esp Salud Pública, 75 (2001), pp. 551-558
[35]
I Casas García, J Ruiz Manzano, A Carreras Molas, A Segura Egea, M Esteve Pardo, X Casas García.
Prevalencia de tuberculosis en una población procedente de Kosovo acogida en España.
Med Clin (Barc), 1 16 (2001), pp. 770-771
[36]
C Salinas Solano, L Altube Urrengoetsea, PP España Yandiola, A Capalastegui Sáez, JM Quintana López.
Tuberculosis en la población inmigrantes de Bilbao.
Arch Bronconeumol, 38 (2002), pp. 506-510
[37]
P Miret Cuadras, JM Pina Gutiérrez.
La prueba de la tuberculina en los vacunados con BCG.
Arch Bronconeumol, 34 (1998), pp. 421-424
[38]
FPJ Rivas Clemente, N Nácher Conches, J Corrillero-Martín, MT García-Herreros Madueño.
Prevalencia de la infección tuberculosa entre los inmigrantes magrebíes.
Med Clin (Barc), 1 14 (2000), pp. 245-249
[39]
FPJ Rivas Clemente, N Nácher Conches, J Corrillero-Martín, S Vélez-Reyes, L Huerta-Galindo.
Resultados de un programa de búsqueda activa de tuberculosis en inmigrantes magrebíes: aceptabilidad y adhesión.
Aten Primaria, 24 (1999), pp. 411-416
Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?