© 2004 by European Journal of Public Health
Infectious Diseases |
Characteristics of tuberculosis patients with positive sputum smear in Catalonia, Spain
P. Godoy1,*, A. Domínguez2, J. Alcaide3, N. Camps4, J.M. Jansà5, S. Minguell6, J.M. Pina7, M. Díez8 and the working group of the Multicentre Tuberculosis Research Project (MTRP)91 Delegación Territorial de Sanidad y Seguridad Social, Lleida, Spain 2 Dirección General de Salud Pública, Generalidad de Cataluña, Barcelona, Spain 3 Programa de Prevención y Control de la Tuberculosis, Generalidad de Cataluña, Barcelona, Spain 4 Delegación Territorial de Sanidad y Seguridad Social, Girona, Spain 5 Instituto Municipal de Salud Pública, Barcelona, Spain 6 Delegación Territorial de Sanidad y Seguridad Social, Tarragona, Spain 7 Programa de Prevención y Control de la Tuberculosis del Área Centro, Terrassa, Spain 8 Subdirección General de Formación y Difusión de la Investigación, Instituto de Salud Carlos III, Madrid, Spain 9 See Note
Background: Patients with positive sputum smears are those with the capacity to spread infection. The objective of this study was to describe the incidence of tuberculosis in Catalonia (an autonomous community in the northeast of Spain which includes Barcelona) and to determine risk factors associated to patients with positive sputum smear test. Methods: New cases of tuberculosis detected by active surveillance between May 1996 and April 1997 were studied. The study was analysed as a coincident cases and controls study. The rate of incidence was calculated per 100,000 persons-year. The association of the dependent variable – case of tuberculosis with positive sputum smear – with the remainder of independent variables was determined by odds ratio (OR) with a 95% confidence interval (CI). Results: A total of 2508 cases of tuberculosis were detected. The rate of incidence was 41.4 per 100,000 persons-year. Of these 19.4% (487/2508) were coinfected with HIV and 35.6% (893/2508) presented a positive sputum smear, which implies a rate of 14.7 per 100,000 persons-year. In an adjusted multivariate analysis, cases with positive smears were positively associated with the 15–24 (OR=1.9; 95% CI: 1.4–2.4), 25–34 (OR=2.1; 95% CI: 1.7–2.7) and 35–44 years (OR=1.7; 95% CI: 1.3–2.2) age compared with persons 45 years old and above; with males (OR=1.8; 95% CI: 1.5–2.2) and consumers of alcohol (OR=2.1; 95% CI: 1.7–2.7) and negatively with those under 15 years of age (OR=0.1; 95% CI: 0.1–0.2) and coinfection with HIV (OR=0.5; 95% CI: 0.3–0.7). Conclusions: Measures to control tuberculosis transmission (prompt diagnosis, study of contacts and directly observed treatments) should be reinforced for male adults with excessive consumption of alcohol.
Keywords: HIV, incidence, positive sputum smear, risk factors, tuberculosis
Received 26 February 2002. Accepted 9 September 2002.
* Correspondence: Dr. P. Godoy, C/ Vall d'Áneu 45, 25199 Lleida, Spain, tel. +34 973 701600, fax +34 973 246562, e-mail: pere.godoy{at}gencat.net