Evaluation of tuberculosis trends in Spain, 1991-1999

SETTING: There are no reliable official data available on tuberculosis (TB) in Spain.OBJECTIVE: To ascertain the epidemiological trends of TB in Spain from 1991-1999.METHODS: In an annual survey conducted by the Tuberculosis and Respiratory Infections (TRI) Working Group of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), data on tuberculosis disease and infection were solicited from two information sources: 1) the public health services of the 17 Autonomous Regions (AR), and 2) 60 TRI members in different parts of Spain.RESULTS: TB incidence declined from 36.4/100000 in 1991 to 26.7 in 1999 according to the AR (average annual decline 3.3%), and from 45.6 to 26.8 according to TRI members (annual decline 5.1%). A similar observation was made for smear-positive cases (AR annual decline: 3.0%; TRI: 5.6%). Tuberculosis infection at 6 years of age also decreased according to both information sources (AR: 0.87% in 1991 to 0.5% in 1998, annual decline 6%, and TRI members: 1.00% in 1991 and 0.9% in 1997, annual decline 4.2%).CONCLUSIONS: The observed rates of TB are higher than stated in official figures. In spite of the decreasing trend, observed declines are small and the current rates continue to be among the highest among industrialised countries.