Decreased Tuberculosis Incidence and Declining Clustered Case Rates, Madrid
2008

Decreased Tuberculosis Incidence in Madrid

Sample size: 789 publication 10 minutes Evidence: moderate

Author Information

Author(s): Iñigo Jesús, Arce Araceli, Palenque Elia, García de Viedma Darío, Chaves Fernando

Primary Institution: Consejería de Sanidad Comunidad de Madrid, Madrid, Spain

Hypothesis

To determine the effect of recent tuberculosis transmission rates on incidence rates in Madrid.

Conclusion

The incidence of tuberculosis in Madrid decreased from 1997 through 2004, primarily due to declining rates of recent transmission among the native Spanish-born population.

Supporting Evidence

  • TB case rates in Madrid decreased from 30.2 cases/100,000 to 25.7 cases/100,000 between the two study periods.
  • The proportion of foreign-born TB patients increased significantly from 5.3% to 34.0%.
  • Clustering of TB cases decreased from 7.0 to 4.4 cases/100,000.
  • Among Spanish-born persons, the incidence of clustered and nonclustered cases declined significantly.
  • Overall incidence of TB among foreign-born persons did not change significantly, but nonclustered cases increased.

Takeaway

In Madrid, fewer people are getting tuberculosis now than before, especially among those born in Spain, but more cases are being seen in people from other countries.

Methodology

Two prospective population-based studies were conducted in urban districts of Madrid, analyzing TB patients over two periods using genotyping and epidemiologic investigation.

Potential Biases

Potential bias in the availability of isolates for molecular typing and the demographic representation of TB cases.

Limitations

The study may underestimate the percentage of foreign-born persons involved in recent transmission due to difficulties in surveying this mobile population.

Participant Demographics

The study included TB patients from three urban districts in Madrid, with a notable increase in foreign-born patients from 5.3% to 34.0% between the two periods.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 1.8–6.1

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.3201/eid1410.080233

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