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3 => "Evaluación"
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"titulo" => "Resumen"
"resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Una vez obtenidas unas cifras aceptables en la identificación y el tratamiento de los enfermos tuberculosos, se plantea una intervención para evitar la aparición de nuevos casos. Las personas con una infección tuberculosa latente (ITL) reciente tienen un mayor riesgo de desarrollar una enfermedad tuberculosa. El objetivo de este estudio es evaluar la prevalencia de ITL y sus factores asociados en los contactos de pacientes tuberculosos.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron los contactos de estos pacientes examinados en el Centro de Prevención y Control de la Tuberculosis de Lleida en el período 1991-1997. Se recogieron factores asociados con el caso índice (demográficos, radiográficos, bacteriológicos y terapéuticos) y el resultado de la prueba de la tuberculina en los contactos y sus datos demográficos. También se recogieron datos del caso índice relacionados con la infección por el VIH, el uso de drogas por vía parenteral y el consumo excesivo de alcohol. Como medida de asociación, se calcularon las <span class="elsevierStyleItalic">odds ratio</span> (OR) crudas y ajustadas (ORa).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La prevalencia global de ITL en los contactos fue del 36,1% (780 de 2.161). En el análisis multivariante se detectó una mayor frecuencia de ITL en los contactos mayores de 14 años (ORa = 3,34; intervalo de confianza [IC] del 95%, 2,51-4,45), en los convivientes (ORa = 1,96; IC del 95%, 1,59-2,42), en los contactos de caso índice con una localización pulmonar de la enfermedad (ORa = 1,54; IC del 95%, 1,01- 2,35), en los de caso índice con baciloscopia positiva en las muestras respiratorias (ORa = 1,51; IC del 95%, 1,15-1,99), en los de caso índice con patrón de cavitaciones en la radiografía de tórax (ORa = 1,27; IC del 95%, 1,01-1,61) y en los de casos índice con demora en el inicio del tratamiento (ORa = 1,31; IC del 95%, 1,05-1,62).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La prevalencia global de ITL en los contactos de enfermos tuberculosos es elevada. Entre los factores estudiados, la demora en el tratamiento del caso índice ha mostrado una asociación independiente con la frecuencia de ITL en los contactos. Deben reforzarse las medidas destinadas al diagnóstico precoz y el tratamiento de los enfermos tuberculosos.</p>"
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"en" => array:2 [
"titulo" => "Abstract"
"resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">As tuberculosis control programs have reached acceptable levels in the identification and treatment of persons with active tuberculosis, the next step should be to develop methods of preventing new cases. Persons with latent tuberculosis infection (LTI) are considered to have a higher risk of developing active tuberculosis. The objective of this study was to evaluate the prevalence of LTI and its associated factors in the contacts of tuberculosis patients.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We studied the contacts of tuberculosis patients who were examined in the Center for Tuberculosis Control and Prevention in Lleida (Spain) from 1991-1997. Factors associated with the index case (demographic, radiographic, bacteriologic and therapeutic) and tuberculin skin test results and demographic data in contacts were collected. Data on HIV infection, injection drug use and alcohol consumption in tuberculosis patients were also collected. The associations were assessed by obtaining crude and adjusted odds ratios.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The prevalence of LTI among contacts was 36.1% (780/2,161). In the multivariate analysis a higher frequency of LTI was detected in contacts older than 14 years (ORa = 3.34; 95% CI, 2.51-4.45), contacts who had a higher degree of exposure to the index case (ORa = 1.96; 95% CI, 1.59-2.42), contacts of pulmonary tuberculosis patients (ORa = 1.54; 95% CI, 1.01-2.35), contacts of patients with a positive sputum smear (ORa = 1.51; 95% CI, 1.15-1.99), contacts of patients with caverns on chest x-ray (ORa = 1.27; 95% CI, 1.01-1.61) and contacts of patients with delayed treatment (ORa = 1.31; 95% CI, 1.05-1.62).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The overall prevalence of LTI in the contacts of patients with tuberculosis was high. Among the factors studied, delayed treatment in the index case was independently associated with the frequency of LTI in tuberculosis contacts. Measures for the early diagnosis and treatment of tuberculosis should be intensified.</p>"
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