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背景:西班牙官方无可靠的结核病疫情资料。目的:确定西班牙 1991-1999年间结核病疫情的流行病学趋势。方法:在西班牙肺病和胸部外科联合会(SEPAR),结核和呼吸系感染(TRI)工作组实施的年度调查研究中,从两种途径收集了结核病的发病以及感染资料:1)17个自治地区(AR)的公共卫生服务资料;2)分布于西班牙不同地区的60个TRI成员收集的信息资料。结果:根据 AR途径的资料,结核病发病率从 1991年的 36.4/10万下降到1999年的 26.7/10万(平均年递降率为3.3％);根据TRI途径的资料,结核病发病率则从45.6/10万下降到 26.8/10万(平均年递降率为5.1％)。关于涂阳肺结核也有类似的观察结 果(AR途径的年递降率为3.0％;TRI途径的年递降率为5.6％)。两种来源的资料都说明6岁儿童的结核感染率也在下降(AR途径的结核感染率从1991年的0.87％下降到1998年的0.5％,年递降率为 6％;TRI途径的结核感染率则从 1991年的1.00％下降到 1997年的 0.71％,年递降率为 4.2％)。结论:本研究观察到的结核病发病率要高于官方公布的数据。尽管结核病发病率存在下降趋势,但递降率很低,西班牙仍然是工业化国家中结核病发病率最高的国家之一。
Background: There is no reliable information on the epidemic of tuberculosis in Spain. Purpose: To determine the epidemiological trend of tuberculosis outbreak in Spain from 1991 to 1999. METHODS: The incidence of tuberculosis and its infection were collected from two sources in the annual survey conducted by the Spanish Federation of Tuberculosis and Thoracic Surgery (SEPAR), Tuberculosis and Respiratory Infection (TRI) Task Force: 1) 17 Autonomous Regions (AR); 2) information collected by 60 TRI members located in different parts of Spain. Results: According to data from the AR pathway, the incidence of tuberculosis dropped from 36.4 / 100 000 in 1991 to 26.7 / 100 000 in 1999 (with an average annual decline rate of 3.3%). According to the TRI pathway, the incidence of TB increased from 45.6 / 100,000 down to 26.8 / 100,000 (with an average annual rate of decline of 5.1%). Similar observations were also made regarding smear-positive pulmonary tuberculosis (3.0% annual decline in the AR pathway and 5.6% annual decline in the TRI pathway). Data from both sources indicate that the incidence of tuberculosis among 6-year-old children is also declining (the prevalence of tuberculosis in the AR pathway dropped from 0.87% in 1991 to 0.5% in 1998 with an annual decline rate of 6%; tuberculosis infection in the TRI pathway The rate dropped from 1.00% in 1991 to 0.71% in 1997, with an annual rate of decline of 4.2%). Conclusions: The incidence of tuberculosis observed in this study is higher than that of the official data. Despite the declining trend in the incidence of tuberculosis, the rate of decline is low and Spain remains one of the countries with the highest incidence of tuberculosis in industrialized countries.