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        "resumen" => "<span class="elsevierStyleSectionTitle">OBJECTIVE</span><p class="elsevierStyleSimplePara elsevierViewall">To investigate the incidence of tuberculosis &#40;TB&#41; in a cohort of contacts and to analyze the variables associated with the disease&#46;</p> <span class="elsevierStyleSectionTitle">METHODS</span><p class="elsevierStyleSimplePara elsevierViewall">A prospective analysis was undertaken of all the contact investigations carried out in a health district in the Basque Country in northern Spain between January 1&#44; 1995 and December 31&#44; 2004&#46; The dependent variable was the number of cases of TB detected among the contacts&#46; Independent variables were age&#44; sex&#44; tuberculin skin test result&#44; and the degree of contact&#46; In index cases&#44; additional variables were the site of the disease and smear test result&#46;</p> <span class="elsevierStyleSectionTitle">RESULTS</span><p class="elsevierStyleSimplePara elsevierViewall">Analysis of 5444 contacts of 596 patients with TB yielded 66 secondary cases of TB &#40;40 at the time of the contact investigation and 26 at a later stage&#41;&#59; the majority &#40;73&#37;&#41; developed the disease within 12 months&#46; Multivariate analysis revealed a significant relationship between the detection of secondary cases and the following variables&#58; close contact &#40;odds ratio &#91;OR&#93;&#44; 3&#46;05&#59; 95&#37; confidence interval &#91;CI&#93;&#44; 1&#46;75-5&#46;31&#41;&#44; positive smear test &#40;OR&#44; 8&#46;54&#59; 95&#37; CI&#44; 2&#46;06-35&#46;43&#41;&#44; induration of 10 mm or larger &#40;OR&#44; 10&#46;18&#59; 95&#37; CI&#44; 4&#46;27-24&#46;26&#41;&#44; and age under 30 years &#40;OR&#44; 3&#46;35&#59; 95&#37; CI&#44; 1&#46;88-5&#46;98&#41;&#46; The final predictive model constructed on the basis of these 3 variables had a sensitivity of 77&#46;4&#37;&#44; a specificity of 80&#46;3&#37;&#44; and an area under the curve of 0&#46;83 &#40;95&#37; CI&#44; 0&#46;78-0&#46;88&#41;&#46;</p> <span class="elsevierStyleSectionTitle">CONCLUSIONS</span><p class="elsevierStyleSimplePara elsevierViewall">The contact investigation is a valid strategy for the detection of new cases of TB&#46; Prophylactic treatment should be implemented at an early stage&#44; and priority should be given to young contacts of smear-positive patients using an induration size of 10 mm or more as a reference&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">OBJETIVO</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer la incidencia de tuberculosis &#40;TB&#41; en una cohorte de contactos y analizar las variables asociadas a la enfermedad&#46;</p> <span class="elsevierStyleSectionTitle">M&#201;TODOS</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha efectuado un an&#225;lisis prospectivo de los estudios de contactos &#40;EC&#41; realizados en un &#225;rea sanitaria del Pa&#237;s Vasco del 1 de enero de 1995 al 31 de diciembre de 2004&#46; La variable dependiente fue el n&#250;mero de casos de TB detectados entre los contactos&#46; Las variables independientes fueron la edad&#44; el sexo&#44; la prueba de la tuberculina &#40;PT&#41; y el grado de contacto&#44; y en los casos &#237;ndice&#44; la localizaci&#243;n de la TB y la baciloscopia del esputo&#46;</p> <span class="elsevierStyleSectionTitle">RESULTADOS</span><p class="elsevierStyleSimplePara elsevierViewall">De los 5&#46;444 contactos de 596 pacientes con TB que se estudiaron&#44; se encontraron 66 casos secundarios de TB &#40;40 en el momento del EC y 26 en el per&#237;odo posterior&#41;&#44; la mayor&#237;a de ellos &#40;73&#37;&#41; durante el primer a&#241;o&#46; El an&#225;lisis multivariante demostr&#243; una relaci&#243;n significativa entre la detecci&#243;n de casos secundarios y las siguientes variables&#58; contacto &#237;ntimo &#40;<span class="elsevierStyleItalic">odds ratio</span> &#91;OR&#93; &#61; 3&#44;05&#59; intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 1&#44;75-5&#44;31&#41;&#44; baciloscopia positiva &#40;OR &#61; 8&#44;54&#59; IC del 95&#37;&#44; 2&#44;06-35&#44;43&#41;&#44; PT de 10 mm o mayor &#40;OR &#61; 10&#44;18&#59; IC del 95&#37;&#44; 4&#44;27-24&#44;26&#41; y edad inferior a 30 a&#241;os &#40;OR &#61; 3&#44;35&#59; IC del 95&#37;&#44; 1&#44;88-5&#44;98&#41;&#46; El modelo predictivo final que se obtuvo utilizando estas 3 variables alcanz&#243; una sensibilidad del 77&#44;4&#37;&#44; una especificidad del 80&#44;3&#37; y un &#225;rea bajo la curva de 0&#44;83 &#40;IC del 95&#37;&#44; 0&#44;78-0&#44;88&#41;&#46;</p> <span class="elsevierStyleSectionTitle">CONCLUSIONES</span><p class="elsevierStyleSimplePara elsevierViewall">El EC es una estrategia v&#225;lida para la detecci&#243;n de nuevos casos de TB&#46; La intervenci&#243;n profil&#225;ctica deber&#237;a realizarse de forma precoz y dirigirse prioritariamente a los contactos j&#243;venes de pacientes bacil&#237;feros&#44; utilizando como referencia una PT de 10 mm o mayor&#46;</p>"
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Vol. 43. Issue 6.
Pages 317-323 (January 2007)
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Vol. 43. Issue 6.
Pages 317-323 (January 2007)
Original Articles
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Longitudinal Incidence of Tuberculosis in a Cohort of Contacts: Factors Associated With the Disease
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3718
Carlos Salinasa,
Corresponding author
csalinas@hgda.osakidetza.net

Correspondence: Dr. C. Salinas, Servicio de Neumología. Hospital de Galdakao. B.° Labeaga, s/n, 48960 Galdakao. Bizkaia. España
, Alberto Capelasteguia, Lander Altubea, Pedro Pablo Españaa, Rosa Díeza, Mikel Oribea, Isabel Urrutiaa, Urko Aguirreb
a Servicio de Neumología, Hospital de Galdakao, Galdakao, Bizkaia, Spain
b Unidad de Investigación, Hospital de Galdakao, Galdakao, Bizkaia, Spain
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OBJECTIVE

To investigate the incidence of tuberculosis (TB) in a cohort of contacts and to analyze the variables associated with the disease.

METHODS

A prospective analysis was undertaken of all the contact investigations carried out in a health district in the Basque Country in northern Spain between January 1, 1995 and December 31, 2004. The dependent variable was the number of cases of TB detected among the contacts. Independent variables were age, sex, tuberculin skin test result, and the degree of contact. In index cases, additional variables were the site of the disease and smear test result.

RESULTS

Analysis of 5444 contacts of 596 patients with TB yielded 66 secondary cases of TB (40 at the time of the contact investigation and 26 at a later stage); the majority (73%) developed the disease within 12 months. Multivariate analysis revealed a significant relationship between the detection of secondary cases and the following variables: close contact (odds ratio [OR], 3.05; 95% confidence interval [CI], 1.75-5.31), positive smear test (OR, 8.54; 95% CI, 2.06-35.43), induration of 10 mm or larger (OR, 10.18; 95% CI, 4.27-24.26), and age under 30 years (OR, 3.35; 95% CI, 1.88-5.98). The final predictive model constructed on the basis of these 3 variables had a sensitivity of 77.4%, a specificity of 80.3%, and an area under the curve of 0.83 (95% CI, 0.78-0.88).

CONCLUSIONS

The contact investigation is a valid strategy for the detection of new cases of TB. Prophylactic treatment should be implemented at an early stage, and priority should be given to young contacts of smear-positive patients using an induration size of 10 mm or more as a reference.

Key words:
Tuberculosis
Contact investigation
Risk factors
OBJETIVO

Conocer la incidencia de tuberculosis (TB) en una cohorte de contactos y analizar las variables asociadas a la enfermedad.

MÉTODOS

Se ha efectuado un análisis prospectivo de los estudios de contactos (EC) realizados en un área sanitaria del País Vasco del 1 de enero de 1995 al 31 de diciembre de 2004. La variable dependiente fue el número de casos de TB detectados entre los contactos. Las variables independientes fueron la edad, el sexo, la prueba de la tuberculina (PT) y el grado de contacto, y en los casos índice, la localización de la TB y la baciloscopia del esputo.

RESULTADOS

De los 5.444 contactos de 596 pacientes con TB que se estudiaron, se encontraron 66 casos secundarios de TB (40 en el momento del EC y 26 en el período posterior), la mayoría de ellos (73%) durante el primer año. El análisis multivariante demostró una relación significativa entre la detección de casos secundarios y las siguientes variables: contacto íntimo (odds ratio [OR] = 3,05; intervalo de confianza [IC] del 95%, 1,75-5,31), baciloscopia positiva (OR = 8,54; IC del 95%, 2,06-35,43), PT de 10 mm o mayor (OR = 10,18; IC del 95%, 4,27-24,26) y edad inferior a 30 años (OR = 3,35; IC del 95%, 1,88-5,98). El modelo predictivo final que se obtuvo utilizando estas 3 variables alcanzó una sensibilidad del 77,4%, una especificidad del 80,3% y un área bajo la curva de 0,83 (IC del 95%, 0,78-0,88).

CONCLUSIONES

El EC es una estrategia válida para la detección de nuevos casos de TB. La intervención profiláctica debería realizarse de forma precoz y dirigirse prioritariamente a los contactos jóvenes de pacientes bacilíferos, utilizando como referencia una PT de 10 mm o mayor.

Palabras clave:
Tuberculosis
Estudio de contactos
Factores de riesgo
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