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J Alcaide Megías

Publications and source records attributed to J Alcaide Megías.

13 recordsLinked to original sources
PubMed2006

[Control and elimination of tuberculosis in Spain: recommendations for the twenty-first century].

OBJECTIVE: The objective of tuberculosis (TBC) control is to eradicate the disease by interrupting transmission of Mycobacterium tuberculosis. The WHO's strategy to achieve global control of this disease is known as directly observed treatment, short-course (DOTS). The goals are to detect 70% of cases of bacilliferous TBC and to successfully treat 85% of these cases in order to reduce the number of sources of infection. Analysis of the epidemiology of TBC in Spain has revealed an incidence of > 20 cases per 100,000 inhabitants. METHODS: The strategies that should be applied are those for disease control: to improve case detection and treatment of cases with surveillance of cure (especially in contagious cases), to identify, investigate and treat individuals exposed to contagious persons, and to control epidemic outbreaks of TBC. Treatment of infected individuals is an elimination strategy and should be reserved for groups at high risk of developing the disease.

Humans↗
PubMed2004

[Active tuberculosis case finding among immigrants in Barcelona].

OBJECTIVE: To assess the prevalence of tuberculous infection and disease in recent economic immigrants in Barcelona. SUBJECTS AND METHOD: Examination and testing of immigrants. Tuberculin tests (TTs) were given and the presence of scars from tuberculosis vaccinations were noted. Thresholds of 5 and 15 mm were established for positivity in unvaccinated and vaccinated individuals, respectively. RESULTS: A total of 3651 persons were examined, but only 3151 completed the study. Eighteen were diagnosed with tuberculosis (571.2 per 100,000) and 50.6% were classified as positive TT reactors, 34.4% because of infection and 16.3% possibly because of tuberculosis vaccination. The percentage of reactors was significantly higher in the sample of economic immigrants than in the local population. Age, male sex, place of origin, greater poverty, and higher prevalence of disease in the country of origin were associated with tuberculous infection in the sample. DISCUSSION: Active case finding proved efficient. Interference from tuberculosis vaccination greatly affects the findings, depending on the positivity threshold that is established. We recommend that chest radiographs be used in addition to TTs. Immigration will change the nature of endemic tuberculosis in Spain, and strategies should be specifically designed to deal with the new challenges that will appear.

Adolescent↗
PubMed2003

[Pulmonary symptomatic tuberculosis' diagnostic delay study].

OBJECTIVE: To study symptomatic pulmonary tuberculosis (PTB) diagnostic delay. PATIENTS AND METHODS: Prospective study of new symptomatic PTB cases (aged > or = 15 years) by structured interview with the patients and their families. The main variables analyzed were patient's delay (PD), doctor's delay (DD), diagnostic process delay (DPD), health care system delay (HCSD) and total delay between the onset of symptoms and start of treatment (TD). Univariate and multivariate statistical analyses were performed for each component of delay. RESULTS: Two hundred eighty-seven patients were studied. The mean delays in days standard deviations were TD 81.8 77.3; PD 43.3 55.7; DD 28.4 59.6; DPD 10.0 17.7, and HCSD 38.5 62.5. CONCLUSIONS: Patients are responsible for 50% of excess delay in diagnosing symptomatic PTB. Patients in the health care system experienced diagnostic delays over 60 days in 18.5% of cases, doctors being responsible for 75% of the diagnostic delay attributable to the system.

Adolescent↗
PubMed2003

[A study of the tuberculous infection in adults].

UNLABELLED: Tuberculous infection in adults is not a well known entity in our country, despite its epidemiological importance. We have designed an observational study in a homogeneous group of adult civil servants of Catalonia (n = 8,202) from 20 to 54 years old that were submitted to a health examination which included a tuberculin test, in order to study the tuberculous infection in these people and to evaluate the factors associated with this infection. RESULTS: The global prevalence of reactivity in tuberculin test was 22.36% and the prevalence of the tuberculous infection was 14.76%. The factors related to the tuberculous infection were the following: age, male sex, background of exposure to sources of contagion, and previous BCG vaccination. CONCLUSIONS: The prevalence of tuberculous infection in adults has declined, and is currently greater in men than women, among patients who recognize previous contact with a tuberculous patient, and among patients with previous BCG vaccination.

Adult↗
PubMed2000

[Epidemiology of tuberculosis].

AIM: To analyze the current epidemiological trend of childhood tuberculosis in Spain. METHODS: The annual reports from Tuberculosis and Respiratory Infections Group of the Spanish Society of Respiratory Disease and from the Multicenter Project for Tuberculosis Research Study Group (1996-1997) were used. The "mirror technique" was applied to detect interference in the interpretation of the tuberculin skin test in a tuberculin survey carried out in 51,877 schoolchildren (aged 418 years). The sensitivity, specificity, positive predictive value and negative predictive value of the test were evaluated. RESULTS: The incidence rate in 13 Autonomous Communities was 12.79 per 100,000 inhabitants. In 1998 the prevalence of this infection was 0.53% at 6 years and 4.7% at 14 years. A cutoff point of 13 mm showed the highest sensitivity, specificity, positive predictive value and negative predictive value. CONCLUSIONS: The trend in childhood tuberculosis during the last few years has been favorable. Interference by nontuberculous mycobacterial infection in the prevalence of the tuberculin skin test was detected. Consequently, use of the American Thoracic Society's guidelines for the interpretation of the tuberculin skin test, with some modifications, is recommended.

Adolescent↗
PubMed1999

[Results and epidemiological impact of directly observed treatment of tuberculosis].

OBJECTIVES: To analyze the results and epidemiological impact on tuberculosis (TB) of directly observed therapy (DOT) for uncooperative patients. METHOD: Retrospective study of the case histories of patients admitted to the DOT unit in Catalonia (Spain) since its March 1993 inauguration until August 1998. RESULTS: Of a total of 470 patients, 102 were cared for during the unit's first phase, in which funding resources were insufficient. Of the 368 admitted during the second phase beginning January 1996; 176 (47.5%) were cured, 27 (7.3%) died, 72 (19.5%) were still at the unit and 93 (25.2%) left the unit before completing treatment. Of the last group, 25 were cured, 31 died 19 continued DOT and 18 (4.9% of all enrolled in the second phase) were lost to follow-up. Thus, the final outcome distribution for the patients was 201 (54.6%) cured, 58 (15.7% died, 91 (24.7%) still in DOT and 18 (4.9%) lost to follow-up. The compliance rate during the second phase was 91.8%. These results may have contributed significantly to the nearly 30% reduction in the incidence of TB in Catalonia between 1992 and 1997, a period which saw large decreases in the number of cases among 20-to-44-year-olds (33%) and consequently also among under-15-year-olds (55%). Likewise the number of cases of TB in high risk groups decreased, 55% on the average with a minimum decrease of 40.1% among AIDS patients and a maximum decrease of 85.2% among indigents. CONCLUSION: DOT has proven highly effective both for patients and for the community, although many other factors must also be considered when accounting for the current epidemiological trend.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Tuberculosis epidemiology in Catalonia: 1982-1989].

The epidemiological indicators of tuberculosis in Catalonia and their trends since 1982 were evaluated. It was shown that the reported morbidity rate has increased because of an increased number of reports, but it probably is still lower than the real one. The epidemiological value of the parameters of tuberculous infection was also shown, particularly the yearly infection rate (YIR), or probability of an individual to be infected. In spite of the multiple interferences that these indexes may have undergone during the past BCG vaccination campaign, their reduction is very important, the yearly reduction of YIR being estimated in 11%.

Age Factors↗
PubMed1990

[Influence of health education on compliance with antituberculous chemoprophylaxis in children: a community trial].

Antituberculous chemoprophylaxis with isoniazide during a period of one year is very useful although it is not readily accepted. A community trial is designed in order to test if three health education interventions increase patients compliance with such treatment in case of tuberculin positive children who are not ill. The two interventions performed by nurses, one by phone, and the second one by a home visit, resulted in statistically significant difference when compared to the control group. This did not occur, however, with the intervention performed by the doctor in his office. A cost-effectiveness study demonstrates that the most efficient intervention has been the phone call.

Child↗
PubMed1982

[BCG vaccination, Critical study (author's transl)].

On the observation that vaccination BCG used during the campaign of erradication of tuberculosis produced a very low conversion of tuberculin reaction postvaccination, authors have studied two groups of children vaccinated with a different BCG vaccine. They have controlled postvaccination allergy and the protection offered by the vaccines when this children are highly exposed to TB. They conclude that vaccination's efficacy is not present and today there are not indications for its' use.

BCG Vaccine↗
PubMedDate not supplied

[Tubercular infection and its trend among school children in the population of the Barcelona suburbs].

BACKGROUND: Tuberculosis infection is a suitable method to evaluate a community tuberculosis endemic. The calculation of infection indexes (incidence, prevalence, year risk and their decline) have been used to analyze this endemic and ist tendency during 22 years in a suburbial city. METHODS: Practice of the tuberculin test (Mantowx) to almost the totality of schoolchildren during the academic years. 1968-69, 1980-81 and 1981-82; and 1989-90 and 1990-91 as well. During the years 1981-82 and 1990-91, the test was repeated in a sample of schoolchildren to detect the reaction converters (incidence of infection). RESULTS: The prevalence of tuberculosis infection is very high (7.5% in the first primary school year and 15.2% in the 8th primary school year during 1968-69, and decreases to 5.1% and 11.7% during 1980-82 was 2.6% and 1.5% in 1989-91. The decline of the infection risk is very low: about 6% during the whole period, and it is higher: 9%, in its second part. CONCLUSIONS: The high tuberculosis can be related to the population social deficiencies. The favourable tendency observed, during the last ten years, can be attributed to an improvement in the health care and, specifically, in the treatment of patients of tuberculosis.

Child↗