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Vol. 23. Issue 4.
Pages 181-191 (July - August 1987)
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Vol. 23. Issue 4.
Pages 181-191 (July - August 1987)
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La evolucion de la tuberculosis en españa: situacion actual. Dificultades y errores epidemiologicos
Evolution of tuberculosis in Spain: current status. Difficulties and epidemiologic misconceptions
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P. De March
Director del Dispensario Enfermedades de Tórax. Barcelona
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La evolución epidemiológica natural de la tuberculosis demuestra la imposibilidad de su incremento en España. El nivel de desarrollo económicosodal alcanzado imposibilita cualquier influencia negativa sobre la misma. Persiste, sin embargo, una elevada morbilidad e infección cuyo lento declive no se corresponde con la inversión sanitaria que realiza el país.

La incidencia de enfermos demuestra una desproporcionada notificación de niños respecto a los adultos y viejos motivada por erróneas declaraciones infantiles y deficitarias en adultos. El único parámetro fiable representado por la incidencia de meningitis tuberculosa en menores de cinco años demuestra una tendencia regresiva en los últimos 13 años.

La infección evidencia un constante declive desde 1921 acelerado a partir de 1952, general para toda la población española, si bien, debido a la incorrecta organización antituberculosa, no desciende al nivel de los países industrializados. La sobreestimación provocada por la vacunación BCG es la causa de los incongruentes resultados publicados sobre la evolución de la infección.

The natural epidemiologic evolution of tuberculosis in Spain reflects the impossibility of a further increase of the disease in this country, due mainly to the degree of socieconomical development achieved. However, there is a remaining high morbidity and infection which slow decreasing does not correlate with the amount of resources inverted.

The incidence of new cases shows a desproportionate number for children as compared with adult and elderly patients. This is due to erroneous reporting of paediatric cases and lack of reporting of adult cases. The only reliable parameter, which is the incidence of tuberculous meningitis in children aged less than five, has shown a regressive trend for the last 13 years. Tuberculosis infection has shown a steady decrease among the spanish population since 1921, even more marked since 1952. It has not reached however the level of more industrialized countries because of the deficient antituberculous health tare organization. The overestimation induced by BCG vaccination is responsible for the incongruity of the data on the evolution of the infection.

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Copyright © 1987. Sociedad Española de Neumología y Cirugía Torácica
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