European Journal of Epidemiology

, Volume 17, Issue 8, pp 737–742 | Cite as

Incidence of pulmonary tuberculosis and HIV coinfection in the province of Seville, Spain, 1998

  • J.M. Mayoral Cortés
  • M. García Fernández
  • M.C. Varela Santos
  • J.C. Fernández Merino
  • J. García León
  • D. Herrera Guibert
  • F. Martínez Navarro
Article

Abstract

Using the National Notifiable Disease Surveillance System (NNDSS) and Minimum Basic Data Set (MBDS) for hospital discharges we evaluated pulmonary tuberculosis (PTB) surveillance and estimated real PTB incidence and human immunodeficiency virus (HIV) coinfection in Seville in 1998. In addition, we assessed the sensitivity and the positive predictive value (PPV) of the surveillance system. Real incidence of pulmonary tuberculosis was estimated by the capture–recapture method. In 1998, the province of Seville reported 225 cases of pulmonary tuberculosis to the NNDSS, an incidence of 13.2 per 100,000 population. Of the 225 cases reported, 18.2% presented with HIV coinfection, while a total of 194 had confirmed diagnoses. The MBDS accounted for 106 new cases. Of these, 24.8% presented with HIV coinfection and were 58% less likely to be reported to the NNDSS (25–76%, p = 0.001). Applying the capture–recapture method, 426 cases were estimated, an overall incidence of 25.6 per 100,000 population (21.5–28.8). Completeness for each source was similar (47%), and for both jointly was 72.7%. The NNDSS had a sensitivity of 65.3% and a PPV of 89.3%. In conclusion, the NNDSS underestimates PTB and PTB-HIV coinfection in Seville. The high incidence observed in young adults suggests a high degree of tuberculosis endemicity. Hospital records provide a readily accessible, low-cost means of estimating disease incidence.

Capture–recapture Epidemiological surveillance HIV Pulmonary tuberculosis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    World Health Organisation. Global Tuberculosis Programme. Global Tuberculosis Control. WHO Report 1999.Google Scholar
  2. 2.
    Consejería de Salud de la Junta de Andalucía (Andalusian Regional Health Authority). Servicio de información y evaluación. Unidad de estadístia. Memoria Estadística de la Consejería de Salud, 1999. ISBN: 84-89704-66-X. Dep. Legal: SE-2573/99.Google Scholar
  3. 3.
    Ministerio de Sanidad y Consumo (Ministry of Health & Consumer Affairs). Royal Decree 2210/1995 of 28 December, governing the setting-up of the national epidemiological surveillance network. Government Gazette (B.O.E.) 24 January 1996; 21: 2153–2158.Google Scholar
  4. 4.
    Consejería de Salud de la Junta de Andalucía (Andalusian Regional Health Authority). Order of 19 December governing the development of the epidemiological surveillance system in the Andalusian Autonomous Region (Comunidad Autońoma de Andalucía) and establishing the Statutorily Noti.able Diseases (Enfermedadesde Declaracioń Obligatoria). Andalusian Government Gazette (B.O.J.A.) 9 January 1997; 4: 213–216.Google Scholar
  5. 5.
    Consejería de Salud de la Junta de Andalucía (Andalusian Regional Health Authority). Decree 66/1996 of 13 February setting-up the Epidemiological Surveillance System in the Andalusian Autonomous Region (Comunidad Auto´noma de Andalucía) and regulating same.Andalusian Government Gazette (B.O.J.A.) 19 March 1996; 35: 2731–2734.Google Scholar
  6. 6.
    Hook EB, Regal RR. Capture–recapture methods in epidemiology: Methods and limitations. Epidemiology Review. 1995; 17(2); 243–264.Google Scholar
  7. 7.
    Domingo A, Harnoll R, et al. Analytical considerations in the use of capture–recapture to estimate prevalence: Case studies of the estimation of opiate use in the metropolitan area of Barcelona, Spain. Am J Epidemiol 1998; 148(8): 732–740Google Scholar
  8. 8.
    Hubert B, Desenclos JC. Evaluation de l'exhaustivité et de la représentativé d'un systeme de surveillance par la méthode de capture–recapture. Application á la surveillance des infections á méningocoque en France en 1989 et 1990. Rev Epidém Et Santé Publ 1993; 41: 241–249.Google Scholar
  9. 9.
    Ferrer-Evangelista D, Ballester-Díaz F, et al. Incidencia de la tuberculosis pulmonar: Aplicacioón del mótodo de captura-recaptura. Gac Sanit 1997; 11(3): 115–121.Google Scholar
  10. 10.
    International working group for disease monitoring and forecasting. Capture–recapture and multiplerecord system estimation I: History and theoretical development. Am J Epidemiol 1995; 142(10): 1047–1058.Google Scholar
  11. 11.
    Hook EB, Regal RR. Validity of methods for model selection, weighting for model uncertainty, and small sample adjustment in capture–recapture estimation. Am J Epidemiol 1997; 145(12): 1138–1144.Google Scholar
  12. 12.
    Domingo-Salvany A, Hartnoll RL, et al. Use of capture –recapture to estimate the prevalence of opiate addiction in Barcelona, Spain, 1989. Am J Epidemiol 1995; 141(6): 567–573.Google Scholar
  13. 13.
    Lopez-Siguero JP, Martínez-Aedo MJ, et al. Evaluación de la diabetes tipo I en niños de 0 a 14 años en Málaga (1982–1993). Anales Españoles de Pediatría. 1997; 47(1): 17–22.Google Scholar
  14. 14.
    Iváñez-Gimeno L, Martínez-Navarro JF. Evaluación de la vigilancia epidemiológica de TBC respiratoria en la provincia de Sevilla. Boletín Epidemiológico Semanal. 1997; 5(25): 241–244.Google Scholar
  15. 15.
    Coll-Jordá D, Arteigoitia-Axpe JM, Martínez-Navarro F. Evaluación de la vigilancia epidemiológica de la Brucelosis en la Comunidad Autónoma del País Vasco. Rev Esp Salud Pública 1997; 71(2): 181–187.Google Scholar
  16. 16.
    The International Classi.cation of Diseases, 9th Revision, Clinical Modification. 1978, Commission on Professional and Hospital Activities, Ann Harbor, Michigan 48705.Google Scholar
  17. 17.
    Ministerio de Sanidad y Consumo. Grupo de trabajo de tuberculosis. Consenso Nacional para el control de la tuberculosis en España. Med Clín 1992; 98: 24–31.Google Scholar
  18. 18.
    Consejería de Salud de la Junta de Andalucía (Andalusian Regional Health Authority). Orden de 23 de abril de 1997 por la que se modi.can las de 6 de marzo de 1996, que crean y modifican ficheros automatizados de cará personal gestionados por la Consejerílud B.O.J.A. de 13 de mayo de 1997; 55: 5804–5806.Google Scholar
  19. 19.
    Chapman DG. Some properties of the hypergeometric distribution applications zoological sample censuses. Univ Calif Public Stat 1951; 1: 131–160.Google Scholar
  20. 20.
    Seber GAF. The effect of trap response on tag recapture estimates. Biometrics 1970; 26: 13–22.Google Scholar
  21. 21.
    Steven M, Teutsch R, Elliott Churchill. Principles and Practice of Public Health Surveillance. Oxford University Press, 1994, 164–167.Google Scholar
  22. 22.
    Instituto de Salud Carlos III. La tuberculosis en España: resultados del Proyecto Multicentrico de Investigación sobre Tuberculosis (PMIT). Madrid, 1999. ISBN: 84-930379-3-1. Dep. Legal: M-32312-1999.Google Scholar
  23. 23.
    Rey R, Ausina V, Casal M, et al. Situación de la tuberculosis en España. Una perspectiva sanitaria en precario respecto a los países desarrollados. Med Clín 1995; 105: 703–707.Google Scholar
  24. 24.
    De March P, Garcia A. Tuberculosis y SIDA 15 años despues (1981–1996) nuevas perspectives. Med Clín 1998; 111: 628–634.Google Scholar
  25. 25.
    SeKar CC, Deming WE. On a method of estimating birth and death rates and the extend of registration. Amer Stat Ass J 1949; 44: 100–115.Google Scholar
  26. 26.
    Dean AG, Dean JA, Coulumbier D, Burton AH, et al. Epi Info, Version 6. Atlanta, Georgia: Centers for Disease Control and Prevention, 1994. (Spanish translation: Fernandez-Merino JC, Arias-Bohigas P. Junta de Andalucí a. Consejerí a Salud, 1996. ISBN 84-89704-06-6).Google Scholar
  27. 27.
    Brenner H. Use and limitations of the capture–recapture method in disease monitoring with two dependent sources. Epidemiology 1995; 6: 42–48.Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • J.M. Mayoral Cortés
    • 1
  • M. García Fernández
    • 1
  • M.C. Varela Santos
    • 1
  • J.C. Fernández Merino
    • 2
  • J. García León
    • 2
  • D. Herrera Guibert
    • 1
  • F. Martínez Navarro
    • 3
  1. 1.National Centre for EpidemiologyField Epidemiology Training ProgrammeMadridSpain
  2. 2.Directorate General for Public HealthAndalusian Regional Health AuthorityMadridSpain
  3. 3.National Centre for EpidemiologyCarlos III Institute of Public HealthMadridSpain

Personalised recommendations