Original Articles
Study of Tuberculosis Outbreaks Reported in Catalonia, 1998–2002
Carlos M. Brana,b,c, Joan A. Cayláa,b,c,
, Ángela Domínguezd, Neus Campsd, Pere Godoyd, Angels Orcaub,c, Irene Barrabeigd, José Alcaided,e, Neus Altetd,e, Pep Álvarezd, the Group for the Study of Tuberculosis Outbreaks in Catalonia *
Corresponding author
jcayla@aspb.es
Correspondence: Dr. J.A. Caylà. Servei d'Epidemiologia. Agéncia de Salud Pública. Plaza Lesseps, 1. 08023 Barcelona. España
Correspondence: Dr. J.A. Caylà. Servei d'Epidemiologia. Agéncia de Salud Pública. Plaza Lesseps, 1. 08023 Barcelona. España
a Departamento de Pediatría, Obstetricia y Ginecología, y Medicina Preventiva, Universidad Autónoma de Barcelona, Barcelona, Spain
b Agéncia de Salut Pública de Barcelona, Barcelona, Spain
c Unidad de Investigación en Tuberculosis de Barcelona, Barcelona, Spain
d Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
e Unidad de Tuberculosis, CAP Drassanes, Barcelona, Spain
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Caylà. Servei d'Epidemiologia. Agéncia de Salud Pública. Plaza Lesseps, 1. 08023 Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-07-15" "fechaAceptado" => "2005-11-15" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154386" "palabras" => array:5 [ 0 => "Disease outbreaks" 1 => "Tuberculosis" 2 => "Diagnosis, delayed" 3 => "Secondary cases" 4 => "Contact tracing" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154385" "palabras" => array:5 [ 0 => "Brotes epidémicos" 1 => "Tuberculosis" 2 => "Retraso diagnóstico" 3 => "Casos secundarios" 4 => "Contactos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To analyze the characteristics of tuberculosis outbreaks declared under vigilance programs in Catalonia.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Descriptive study of outbreaks from 1998 through 2002 for which reports were available. An outbreak was defined as 3 or more associated cases appearing within a year. For 2 health care regions, outbreaks for which there were full surveillance reports with contact tracing were compared to outbreaks identified but which had not been fully reported.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Twenty-seven outbreaks were analyzed. Nineteen (70%) occurred within families. A total of 22 outbreaks were declared upon identification of the true index case and 5 upon detection of secondary cases. The mean annual incidence of outbreaks was 0.40/100000 inhabitants.</p><p class="elsevierStyleSimplePara elsevierViewall">Most cases were in males 16 to 40 years of age and involved cavitary lesions and a clinically significant diagnostic delay. Twenty-seven outbreaks caused 69 secondary cases.</p><p class="elsevierStyleSimplePara elsevierViewall">A longer diagnostic delay was seen to correspond to a larger number of secondary cases (<span class="elsevierStyleItalic">P</span>=.08). In the 2 health care regions analyzed, full surveillance reports with contact tracing were issued for 2 of the 14 outbreaks detected (14.4%).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Tuberculosis outbreaks are common but investigative follow-up is scarce. The size of the outbreak is related to the length of diagnostic delay. Rapid diagnosis, contact tracing, and the issuance of a public health report should be priorities in all outbreaks detected.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar las características de los brotes de tuberculosis (TB) estudiados por los servicios de vigilancia epidemiológica de Cataluña.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo de los brotes de 1998–2002 que disponían de informe epidemiológico. Se definió como brote epidémico cuando había 3 o más casos asociados en un año. En 2 regiones sanitarias se compararon los brotes detectados con los que además tenían informes.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se analizaron 27 brotes y la mayoría (n = 19; el 70%) ocurrió en el ámbito familiar. Un total de 22 brotes fueron declarados a partir del caso índice auténtico y 5 a partir de un caso secundario. La incidencia media anual de brotes fue de 0,40/100.000 habitantes. La mayoría fueron generados por varones de 16 a 40 años, con lesiones cavita-rias y un importante retraso diagnóstico. Los 27 brotes provocaron 69 casos secundarios. Se observó que a mayor retraso diagnóstico correspondía mayor número de casos secundarios (p = 0,08). En las 2 regiones sanitarias analiza-das sólo se realizó informe epidemiológico en 2 de los 14 brotes detectados (14,4%).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los brotes de TB son frecuentes pero poco investigados, y el retraso diagnóstico se asoció al tamaño del brote. Se deben priorizar el diagnóstico rápido de los enfermos, el estudio de contactos y la realización de un informe sanitario en cada brote detectado.</p>" ] ] "NotaPie" => array:2 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Partially funded by the Spanish health research fund (Fondo de Investigaciones Sanitarias), network for epidemiological and public health research (Red de Centros de Investigación en Epidemiología y Salud Pública).</p>" ] 1 => array:2 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara">Members of the Group for the Study of Tuberculosis Outbreaks in Catalonia are listed at the end of the article.</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:2 [ "titulo" => "Outbreak of tuberculosis among homeless persons 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 4 | 8 |
| 2024 October | 30 | 16 | 46 |
| 2024 September | 29 | 17 | 46 |
| 2024 August | 44 | 30 | 74 |
| 2024 July | 28 | 21 | 49 |
| 2024 June | 37 | 24 | 61 |
| 2024 May | 32 | 30 | 62 |
| 2024 April | 21 | 20 | 41 |
| 2024 March | 29 | 14 | 43 |
| 2024 February | 17 | 21 | 38 |
| 2024 January | 2 | 0 | 2 |
| 2023 March | 2 | 2 | 4 |
| 2023 February | 15 | 17 | 32 |
| 2023 January | 23 | 24 | 47 |
| 2022 December | 16 | 24 | 40 |
| 2022 November | 15 | 20 | 35 |
| 2022 October | 25 | 26 | 51 |
| 2022 September | 21 | 22 | 43 |
| 2022 August | 13 | 35 | 48 |
| 2022 July | 20 | 35 | 55 |
| 2022 June | 19 | 35 | 54 |
| 2022 May | 14 | 20 | 34 |
| 2022 April | 13 | 20 | 33 |
| 2022 March | 18 | 35 | 53 |
| 2022 February | 16 | 44 | 60 |
| 2022 January | 17 | 27 | 44 |
| 2021 December | 15 | 45 | 60 |
| 2021 November | 18 | 58 | 76 |
| 2021 October | 21 | 46 | 67 |
| 2021 September | 19 | 55 | 74 |
| 2021 August | 15 | 28 | 43 |
| 2021 July | 17 | 28 | 45 |
| 2021 June | 25 | 46 | 71 |
| 2021 May | 15 | 27 | 42 |
| 2021 April | 14 | 45 | 59 |
| 2021 March | 30 | 27 | 57 |
| 2021 February | 9 | 23 | 32 |
| 2021 January | 14 | 9 | 23 |
| 2020 December | 8 | 16 | 24 |
| 2020 November | 14 | 23 | 37 |
| 2020 October | 6 | 7 | 13 |
| 2020 September | 12 | 6 | 18 |
| 2020 August | 8 | 14 | 22 |
| 2020 July | 20 | 19 | 39 |
| 2020 June | 11 | 3 | 14 |
| 2020 May | 14 | 10 | 24 |
| 2020 April | 18 | 19 | 37 |
| 2020 March | 16 | 15 | 31 |
| 2020 February | 13 | 16 | 29 |
| 2020 January | 18 | 14 | 32 |
| 2019 December | 17 | 12 | 29 |
| 2019 November | 10 | 14 | 24 |
| 2019 October | 15 | 7 | 22 |
| 2019 September | 17 | 10 | 27 |
| 2019 August | 11 | 11 | 22 |
| 2019 July | 14 | 17 | 31 |
| 2019 June | 7 | 8 | 15 |
| 2019 May | 10 | 12 | 22 |
| 2019 April | 10 | 27 | 37 |
| 2019 March | 9 | 19 | 28 |
| 2019 February | 12 | 21 | 33 |
| 2019 January | 3 | 21 | 24 |
| 2018 December | 5 | 11 | 16 |
| 2018 November | 8 | 12 | 20 |
| 2018 October | 10 | 14 | 24 |
| 2018 September | 11 | 8 | 19 |
| 2018 May | 7 | 0 | 7 |
| 2018 April | 4 | 6 | 10 |
| 2018 March | 7 | 3 | 10 |
| 2018 February | 5 | 7 | 12 |
| 2018 January | 7 | 5 | 12 |
| 2017 December | 3 | 7 | 10 |
| 2017 November | 4 | 7 | 11 |
| 2017 October | 4 | 10 | 14 |
| 2017 September | 6 | 13 | 19 |
| 2017 August | 7 | 9 | 16 |
| 2017 July | 4 | 5 | 9 |
| 2017 June | 8 | 10 | 18 |
| 2017 May | 7 | 6 | 13 |
| 2017 April | 3 | 3 | 6 |
| 2017 March | 3 | 6 | 9 |
| 2017 February | 2 | 3 | 5 |
| 2017 January | 1 | 3 | 4 |
| 2016 December | 8 | 10 | 18 |
| 2016 November | 11 | 7 | 18 |
| 2016 October | 14 | 5 | 19 |
| 2016 September | 7 | 4 | 11 |
| 2016 August | 11 | 2 | 13 |
| 2016 July | 9 | 0 | 9 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 34 | 8 | 42 |
| 2015 September | 36 | 9 | 45 |
| 2015 August | 32 | 7 | 39 |
| 2015 July | 29 | 1 | 30 |
| 2015 June | 28 | 5 | 33 |
| 2015 May | 40 | 6 | 46 |
| 2015 April | 18 | 11 | 29 |
| 2015 March | 26 | 6 | 32 |
| 2015 February | 25 | 1 | 26 |
| 2015 January | 17 | 4 | 21 |
| 2014 December | 19 | 4 | 23 |
| 2014 November | 9 | 6 | 15 |
| 2014 October | 25 | 6 | 31 |
| 2014 September | 21 | 7 | 28 |
| 2014 August | 21 | 7 | 28 |
| 2014 July | 16 | 7 | 23 |
| 2014 June | 31 | 9 | 40 |
| 2014 May | 36 | 9 | 45 |
| 2014 April | 48 | 8 | 56 |
| 2014 March | 39 | 7 | 46 |
| 2014 February | 26 | 9 | 35 |
| 2014 January | 25 | 7 | 32 |
| 2013 December | 29 | 7 | 36 |
| 2013 November | 18 | 3 | 21 |
| 2013 October | 25 | 11 | 36 |
| 2013 September | 27 | 11 | 38 |
| 2013 August | 25 | 4 | 29 |
| 2013 July | 33 | 15 | 48 |
| 2013 June | 24 | 10 | 34 |
| 2013 May | 34 | 3 | 37 |
| 2013 April | 12 | 3 | 15 |
| 2013 March | 6 | 3 | 9 |
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