Epidemiological trends of tuberculosis in Spain from 1988 to 1992. Collaborative Group for the Study of Tuberculosis in Spain.

SETTING

Spain is one of the few industrialized countries in which reliable official data on the occurrence of tuberculosis are not available.

OBJECTIVE

One of the purposes of the Tuberculosis and Respiratory Infection (TRI) working group established by the Spanish Society of Thoracic Surgery (Sociedad Española de Nuemología y Cirugía Torácica [SEPAR]) in 1988, was to determine the true situation of Mycobacterium tuberculosis infection and active tuberculosis disease in our country.

DESIGN

A questionnaire requesting epidemiological data on tuberculosis was sent to the Departments of Public Health of all the Autonomous Communities in Spain (n = 17) and 60 members of the TRI working group (pneumologists, epidemiologists or microbiologists most actively working in the field of tuberculosis within their corresponding areas of influence). Results obtained for the period 1988 and 1992 were analyzed.

RESULTS

In the 6-year-old group, annual prevalence-of-infection rates were almost 0.95%, with a slight decreasing trend over the study period. In the 14-year-old group, annual figures of around 3% have been registered. The 1992 incidence rates of new cases of tuberculosis and sputum-smear positive tuberculosis were 40 and 21.2 per 100,000, respectively. Frequently distribution by age has shown a similar trend during the study period with a clear predominance in the younger adult age groups. Reliable data in relation to the number of patients with tuberculosis and HIV infection was available in 1992. Of 5290 patients in a population of 16,954,942, there were 792 (15%) with HIV infection.

CONCLUSIONS

The current epidemiological situation of tuberculosis in Spain is one of the most unfavourable as compared with epidemiological data from the remaining industrialized countries. Given the lack of a National Programme for Tuberculosis Control, each Autonomous Community should take responsibility for developing and implementing key control activities based on the cure of infectious cases and case-finding.