5184.0: Wednesday, November 15, 2000 - 2:30 PM

Abstract #16605

Detection of pulmonary tuberculosis in Chiapas, Mexico

Héctor J. Sánchez-Pérez, MD1, Miguel A. Hernán, MD, DrPH2, Sonia Hernández-Díaz2, and Alberto Ascherio, MD, DrPH3. (1) Investigador Titular Area Población y Salud, El Colegio de la Frontera Sur, Carretera Panamericana y Periférico Sur S/n, 29290 San Cristóbal de las Casas, Chiapas, Mexico, 967-818-84, hsanchez@sclc.ecosur.mx, (2) Dept. of Epidemiology, School of Public Health, Harvard University, 677 Huntington Ave, Bonton, MA 02115, (3) Dept. of Nutrition, School of Public Health, Harvard University, 665 Huntington Ave, Boston, MA 02115

Objectives. To estimate the prevalence and degree of undetection of pulmonary tuberculosis (PTB) and the sensitivity of bacilloscopy in the border region of Chiapas, Mexico. Methods. We conducted an active search for persons aged 15 or more with chronic cough in three settings: one regional hospital, seven primary care centers, and 32 communities (general population). Individuals reporting chronic cough were asked to provide three samples of sputum for acid fast smears and cultures. To evaluate the quality of acid-fast smears, the diagnosis provided by culture was the gold standard. Results. We identified a total of 899 individuals with chronic cough and obtained sputum specimens from 590 of them. A diagnosis of PTB was confirmed in 78. The estimated proportion of PTB cases not previously diagnosed was 34% (15/44) at the hospital, 71% (12/17) at the primary care centers, and 76% (13/17) in the communities. A conservative estimate of the prevalence of PTB in the population aged 15 or more was 151 per 100,000 persons (95% confidence interval: 88-241). The sensitivity of the test was about 90% in the hospital, and slightly lower than 50% in the primary care centers and the communities. Conclusions. Improved procedures for PTB detection are required in the studied area to obtain adequate estimates of disease burden and to provide therapy to affected patients.

Learning Objectives: Describe the disease burden for pulmonary TB in Chiapas Mexico Discuss methods of ascertainment for undetected pulmonary TB

Keywords: Tuberculosis, Disease Management

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA