Original Articles
Tuberculosis Epidemiology in Area 15 of the Spanish Autonomous Community of Valencia: Evolution From 1987 Through 2001
J.L. Calpea, E. Chinerb, J. Marínc, V. Armerod, A. Calpea,
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calpe_jos@gva.es
Correspondence: Dr. J.L. Calpe. Servicio de Neumología. Hospital Marina Baixa. Partida Galandú, 5. 03570 Villajoyosa. Alicante. España
Correspondence: Dr. J.L. Calpe. Servicio de Neumología. Hospital Marina Baixa. Partida Galandú, 5. 03570 Villajoyosa. Alicante. España
a Servicio de Neumología, Hospital Marina Baixa, Villajoyosa, Alicante, Spain
b Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
c Servicio de Neumología, Universidad de Valencia, Valencia, Spain
d Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, Spain
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"apellidos" => "Calpe" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "E." "apellidos" => "Chiner" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Marín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "V." "apellidos" => "Armero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 4 => array:5 [ "preGrado" => "Dr." "nombre" => "A." "apellidos" => "Calpe" "email" => array:1 [ 0 => "calpe_jos@gva.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Marina Baixa, Villajoyosa, Alicante, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Universidad de Valencia, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J.L. Calpe. Servicio de Neumología. Hospital Marina Baixa. Partida Galandú, 5. 03570 Villajoyosa. Alicante. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-05-03" "fechaAceptado" => "2004-09-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153970" "palabras" => array:4 [ 0 => "Tuberculosis" 1 => "Epidemiology" 2 => "Human immunodeficiency virus (HIV)" 3 => "Evolution" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153971" "palabras" => array:4 [ 0 => "Tuberculosis" 1 => "Epidemiología" 2 => "Virus de la inmunodeficiencia humana (VIH)" 3 => "Evolución" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">TO describe the evolution of tuberculosis epidemiology in Area 15 of the Autonomous Community of Valencia.</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Cases of tuberculosis were identified by active case finding in Area 15 from January 1987 through December 2001. Clinical and epidemiological data were extracted from case records and a patient interview.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Four hundred seventy-six diagnosed cases of mycobacterial infection were identified (459 tuberculosis, 16 atypical, and 1 mixed); 423 tuberculosis patients were residents of Area 15. The mean annual incidence rate was 24.6/100 000 population, representing a rate decrease of 41.5% from 1990. The most frequent risk factors were smoking (38%), alcoholism (20%), human immunodeficiency virus (HIV) infection (18%), and contact with a tuberculosis patient (14%). The site of tuberculosis involvement was the lung in 61% (49% bacillus positive, with a nonsignificant trend to decrease over time), nonpulmonary in 26%, and mixed in 13%. The radiographic pattern observed most often was pulmonary infiltrates (67%), and lower lobe involvement tended to increase over time. Diagnosis was by acid-fact bacillus stain for 77%, clinical picture for 16%, and histological for 7%. Isoniazid resistance was detected in 1.5% and rifampicin resistance in 0.3%. Patients were hospitalized during diagnosis in 79% of cases; the mean stay was 18 days.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The incidence of tuberculosis has decreased in spite of the HIV pandemic. Risk factors have not changed, bacteriological diagnosis has improved, and the location of pulmonary infiltrates has changed. No influence of immigration on the incidence rate of tuberculosis has been detected to date.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Valorar la evolución de las características epidemiológicas de la enfermedad tuberculosa (TB) en el Área 15 de la Comunidad Valenciana.</p> <span class="elsevierStyleSectionTitle">Material y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Mediante búsqueda activa se identificaron todos los casos de TB diagnosticados en el área des-de enero de 1987 a diciembre de 2001. Se recogió información clínica y epidemiológica de la historia clínica y de la entrevista con el paciente.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se diagnosticaron 476 casos de micobacteriosis (459 TB, 16 atípicas y una mixta), de los cuales eran residentes en el área 423 casos de TB. La tasa media anual fue de 24,6/10<span class="elsevierStyleSup">5</span>, con un descenso del 41,5% desde 1990. Los factores de riesgo más frecuentes fueron: tabaquismo en el 38%, etilismo en el 20%, infección por el virus de la inmunodeficiencia humana (VIH) en el 18% y contacto con TB en el 14%. La localización fue sólo pulmonar en el 61% de los casos (bacilíferos en el 49%, con tendencia a disminuir, aunque no significativamente), extrapulmonar en el 26% y mixta en el 13%; los infiltrados (67%) constituyeron el patrón más frecuente, con tendencia al aumento de incidencia en los lóbulos inferiores. El diagnóstico fue bacteriológico en el 77% de los pacientes, clínico en el 16% e histológico en el 7%. Fueron resistentes a isoniacida el 1,5% de los casos y a rifampicina el 0,3%. El 79% ingresó para diagnóstico, con una estancia media de 18 días.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La TB ha disminuido su tasa, pese a la pandemia del VIH. No hay cambios en los factores de riesgo, se ha mejorado el diagnóstico bacteriológico y hemos observado cambios en la localización de los infiltrados pulmonares. La inmigración no ha tenido por el momento influencia sobre la tasa de TB.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Euro TB (CESES/KNCV) and the National Coordinators for Tuberculosis Surveillance of Tuberculosis in Europe. Report on the feasibility study (1996-1997). Tuberculosis cases notified in 1995. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 30 | 25 | 55 |
| 2024 September | 27 | 21 | 48 |
| 2024 August | 43 | 34 | 77 |
| 2024 July | 25 | 22 | 47 |
| 2024 June | 30 | 23 | 53 |
| 2024 May | 35 | 31 | 66 |
| 2024 April | 17 | 24 | 41 |
| 2024 March | 18 | 15 | 33 |
| 2024 February | 18 | 26 | 44 |
| 2023 March | 1 | 3 | 4 |
| 2023 February | 18 | 20 | 38 |
| 2023 January | 26 | 29 | 55 |
| 2022 December | 21 | 20 | 41 |
| 2022 November | 17 | 22 | 39 |
| 2022 October | 20 | 29 | 49 |
| 2022 September | 15 | 26 | 41 |
| 2022 August | 21 | 31 | 52 |
| 2022 July | 19 | 43 | 62 |
| 2022 June | 15 | 28 | 43 |
| 2022 May | 21 | 37 | 58 |
| 2022 April | 12 | 22 | 34 |
| 2022 March | 19 | 43 | 62 |
| 2022 February | 14 | 25 | 39 |
| 2022 January | 12 | 28 | 40 |
| 2021 December | 14 | 38 | 52 |
| 2021 November | 16 | 41 | 57 |
| 2021 October | 68 | 32 | 100 |
| 2021 September | 41 | 48 | 89 |
| 2021 August | 34 | 29 | 63 |
| 2021 July | 25 | 28 | 53 |
| 2021 June | 17 | 27 | 44 |
| 2021 May | 11 | 22 | 33 |
| 2021 April | 29 | 55 | 84 |
| 2021 March | 11 | 14 | 25 |
| 2021 February | 13 | 13 | 26 |
| 2021 January | 9 | 11 | 20 |
| 2020 December | 4 | 7 | 11 |
| 2020 November | 7 | 9 | 16 |
| 2020 October | 10 | 7 | 17 |
| 2020 September | 1 | 8 | 9 |
| 2020 August | 12 | 6 | 18 |
| 2020 July | 13 | 14 | 27 |
| 2020 June | 6 | 9 | 15 |
| 2020 May | 10 | 7 | 17 |
| 2020 April | 16 | 7 | 23 |
| 2020 March | 14 | 8 | 22 |
| 2020 February | 15 | 15 | 30 |
| 2020 January | 16 | 11 | 27 |
| 2019 December | 16 | 14 | 30 |
| 2019 November | 11 | 8 | 19 |
| 2019 October | 6 | 11 | 17 |
| 2019 September | 7 | 8 | 15 |
| 2019 August | 14 | 3 | 17 |
| 2019 July | 17 | 14 | 31 |
| 2019 June | 10 | 9 | 19 |
| 2019 May | 7 | 4 | 11 |
| 2019 April | 21 | 16 | 37 |
| 2019 March | 12 | 14 | 26 |
| 2019 February | 3 | 7 | 10 |
| 2019 January | 12 | 4 | 16 |
| 2018 December | 5 | 9 | 14 |
| 2018 November | 23 | 9 | 32 |
| 2018 October | 22 | 9 | 31 |
| 2018 September | 11 | 11 | 22 |
| 2018 May | 5 | 1 | 6 |
| 2018 April | 3 | 8 | 11 |
| 2018 March | 11 | 3 | 14 |
| 2018 February | 6 | 8 | 14 |
| 2018 January | 5 | 8 | 13 |
| 2017 December | 9 | 4 | 13 |
| 2017 November | 6 | 4 | 10 |
| 2017 October | 4 | 9 | 13 |
| 2017 September | 5 | 5 | 10 |
| 2017 August | 8 | 8 | 16 |
| 2017 July | 2 | 2 | 4 |
| 2017 June | 9 | 10 | 19 |
| 2017 May | 8 | 16 | 24 |
| 2017 April | 1 | 2 | 3 |
| 2017 March | 4 | 7 | 11 |
| 2017 February | 3 | 2 | 5 |
| 2017 January | 2 | 3 | 5 |
| 2016 December | 8 | 8 | 16 |
| 2016 November | 18 | 11 | 29 |
| 2016 October | 17 | 13 | 30 |
| 2016 September | 13 | 10 | 23 |
| 2016 August | 8 | 5 | 13 |
| 2016 July | 9 | 5 | 14 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 28 | 1 | 29 |
| 2015 September | 26 | 10 | 36 |
| 2015 August | 29 | 6 | 35 |
| 2015 July | 29 | 6 | 35 |
| 2015 June | 26 | 3 | 29 |
| 2015 May | 35 | 10 | 45 |
| 2015 April | 22 | 16 | 38 |
| 2015 March | 24 | 8 | 32 |
| 2015 February | 18 | 4 | 22 |
| 2015 January | 29 | 5 | 34 |
| 2014 December | 19 | 4 | 23 |
| 2014 November | 19 | 4 | 23 |
| 2014 October | 41 | 13 | 54 |
| 2014 September | 24 | 10 | 34 |
| 2014 August | 28 | 13 | 41 |
| 2014 July | 16 | 7 | 23 |
| 2014 June | 35 | 9 | 44 |
| 2014 May | 41 | 8 | 49 |
| 2014 April | 37 | 12 | 49 |
| 2014 March | 32 | 7 | 39 |
| 2014 February | 37 | 5 | 42 |
| 2014 January | 30 | 6 | 36 |
| 2013 December | 27 | 8 | 35 |
| 2013 November | 18 | 6 | 24 |
| 2013 October | 22 | 6 | 28 |
| 2013 September | 34 | 11 | 45 |
| 2013 August | 22 | 4 | 26 |
| 2013 July | 38 | 9 | 47 |
| 2013 June | 23 | 7 | 30 |
| 2013 May | 28 | 5 | 33 |
| 2013 April | 29 | 6 | 35 |
| 2013 March | 5 | 2 | 7 |
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