International Journal of Epidemiology, Vol 28, 135-140, Copyright © 1999 by International Epidemiological Association
ML Garcia-Garcia, PM Small, C Garcia-Sancho, ME Mayar-Maya, L Ferreyra-Reyes, M Palacios-Martinez, S Jimenez, G Canales, G Quiroz, L Yanez and JL Valdespino- Gomez
BACKGROUND: Tuberculosis (TB) rates remain high in regions of Southern
Mexico despite the existence of a National Tuberculosis Program.
Understanding TB epidemiology in such settings would assist in the design
of improved TB control and highlight the challenges confronting TB control
in developing countries. METHODS: We conducted a retrospective review of
treatment control cards from 1991 to 1994 in five municipalities in a
semiurban region of Southern Mexico. RESULTS: The relatively high rate of
TB observed, 42.6 per 100,000 inhabitants, did not change significantly
during the study period. Cure rates among new cases were 79% and
significantly lower among retreatment cases (62%). Directly observed
therapy (DOT) was administered to 84% of patients. Approximately one-half
of the retreatment cases who were not cured were compliant with therapy,
suggesting that drug resistance contributed to these poor results. Of
particular concern was a core group of 16 patients who had received at
least three treatments. CONCLUSIONS: This region of Mexico has persistently
high TB rates despite a DOT-based TB control programme which achieves an
overall cure rate of 77%. There exist many retreatment cases for whom cure
rates are significantly lower. These cases may serve as a core group for
the dissemination of drug resistant TB. The control programme is being
reinforced by a nominal register of patients, decreasing administrative
barriers for drug supply to individual patients and the availability of
mycobacteria cultures. In addition to these measures, in regions which are
approaching the levels of efficacy recommended by the WHO it may be
appropriate to consider focusing efforts on the identification and
treatment of chronic cases.
ARTICLES
Tuberculosis epidemiology and control in Veracruz, Mexico
Instituto Nacional de Salud Publica, Cuernavaca, Mor., Mexico.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. d. L. Garcia-Garcia, A. Ponce-de-Leon, M. E. Jimenez-Corona, A. Jimenez-Corona, M. Palacios-Martinez, S. Balandrano-Campos, L. Ferreyra-Reyes, L. Juarez-Sandino, J. Sifuentes-Osornio, H. Olivera-Diaz, et al. Clinical Consequences and Transmissibility of Drug-Resistant Tuberculosis in Southern Mexico Arch Intern Med, March 13, 2000; 160(5): 630 - 636. [Abstract] [Full Text] [PDF]
|
|