Introduction. The purpose of this article is to present the preliminary results of the epidemiological surveillance of tuberculosis (TB) in Catalonia in 2018 and to assess its evolution in recent years. Methods and results. The epidemiological surveillance of TB in Catalonia combines passive and active surveillance systems. In 2018, 991 cases were reported (13.0 cases per 105 inhabitants). 63.4% of cases are men and 36.6% are women, with a rate of 16.8 cases and 9.4 cases per 105 inhabitants, respectively. The mean age of the patients is 44.3 years, significantly higher in native people (51.5 years) compared to immigrants (37.8 years). Pediatric cases represent 6.4% of the total, with a rate of 5.4 cases per 105 inhabitants. 52.4% of TB cases are immigrants who have presented an incidence rate that is almost 5 times higher than that of native people (37.6 and 7.6 cases per 105 inhabitants, respectively). The most common form of TB is pulmonary, observed in 67.0% of cases (8.7 cases per 105 inhabitants), of which 42.6% have been smear positive (3.7 cases per 105 inhabitants). Diagnostic delay of TB pulmonary cases in 2018 has been higher than one month (median of 53 days) and has increased significantly to that observed among the cases of 2017 (median of 46 days). The primary resistance to any first-line drugs has been 14.4%; to isoniazid, of 7.7%, and simultaneously to isoniazid and rifampicin, of 2.4%. In 83.8% of pulmonary TB cases, a contact investigation has been conducted; a proportion higher than that of 2017, but which rises to 87.8% in smear positive pulmonary TB cases. 88.4% of TB cases who started treatment in 2017 completed it satisfactorily, a higher proportion in women (92.5%) than in men (85.9%), without significant differences between natives and immigrants. With respect to 2017, the TB incidence rate of 2018 has decreased by 1.5%, due to an 8.4% decrease in natives but an increase of 3.6% in immigrants, while in 2017 the reduction observed with respect to the 2016 rate was 0.8%. Conclusions. Despite significant progress in the control of this disease, TB incidence in Catalonia in 2018 shows a slowdown in the decline observed in recent years. This highlights the need to increase control efforts, maintaining the political and technical commitment needed for TB control and its elimination, identifying and treating cases of latent TB infection and thus decreasing the reservoir of the causative agent of this disease.
Tuberculosis; Epidemiological surveillance; Microbiological notification
Jané-Checa M, Prats-Viedma B, Valdivia-Guijarro M, Fernández-Gutiérrez C, García-Lebrón M, López-Espinilla M. La tuberculosi a Catalunya l’any 2018. Butll Epidemiol Catalunya. 2019;40(06):124-134.
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