Analysis of population attended in a tuberculosis unit in Madrid. Evolution and impact of immigration from 1997 to 2006

In Spain there is a high prevalence of tuberculosis (TB). The aim of this study is to describe population attended in an Isolation Unit, analysing the changes that have occurred in 10 years, the impact of immigration and factors that may condition the loss of following. Descriptive study of all patients admitted to the Isolation Unit of Hospital Cantoblanco-La Paz from 1997 to 2006. Univariate analysis and multiple logistic regression analysis were performed. 832 patients were studied, 69.4% men, with a mean age of 40.8 years 37.5% immigrants. In new cases, resistance to isoniazid was documented in 6.7% and multidrug resistance in 3.1%, and in previously treated cases, in 11.2% and 8.4%, respectively. Treatment was completed by 74.1%, 17.5% were lost, which was associated with drugs consumption (OR 3.01; CL 95% 1.18-3.41), being immigrant (OR 2.14; CL 95% 1.42-3.21) and HIV infection (OR 1.96; CL 95% 1.18-3.41). In the 10 years, percentage of immigrants and patients who proceeded from the Emergency Departments increased and results improved, while HIV infection and loss of following reduced. Profile of patient with TB has changed in last years in association with immigration. In spite of better results, more actions are needed in order to improve the adherence and epidemiologic control of the disease. (c) 2009 Elsevier España, S.L. All rights reserved.