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"titulo" => "Microepidemias de tuberculosis en centros escolares. ¿Cómo seleccionar los contactos?"
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"entidad" => "Sección de Epidemiología, Servicio de Salud Pública del Área 7, Instituto de Salud Pública, Comunidad de Madrid, Madrid, España"
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"correspondencia" => "Correspondencia: María del Carmen Álvarez-Castillo. Sección de Epidemiología. Servicio de Salud Pública del Área 7. Maudes, 32. 28003 Madrid. España."
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"titulo" => "Microepidemics of tuberculosis in schools. How should we select contacts?"
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1 => "Tuberculosis"
2 => "Estudio de contactos"
3 => "Microepidemias"
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"resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">La aparición de microepidemias de tuberculosis indica una transmisión de <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>. Se describe una microepidemia en un centro escolar donde se observó un alto porcentaje de infectados y de enfermos a partir de un caso fuente de baja capacidad infectante.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio de contactos a 423 alumnos de un colegio, ante la aparición de un caso de tuberculosis en una profesora con escasa sintomatología y poco tiempo de exposición en el centro. Estudio transversal donde se calcula la prevalencia de enfermedad y de infección tuberculosa en el centro escolar.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se hallaron diferencias estadísticamente significativas en la distribución de casos positivos en la primera prueba de tuberculina por ciclo escolar, y se encontraron más alumnos positivos en educación secundaria (18,4%) que en primaria (6,1%). La incidencia de conversores tuberculínicos fue del 5,7%. La prevalencia de infección por nivel educativo fue del 10% en educación primaria y del 23,4% en educación secundaria. El riesgo de infección en alumnos de educación secundaria fue más del doble que los de primaria (<span class="elsevierStyleItalic">odds ratio</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2,4; intervalo de confianza del 95%, 1,5-3,5). Aparecieron 6 casos de tuberculosis en los alumnos.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p class="elsevierStyleSimplePara elsevierViewall">El alto porcentaje de conversiones en la segunda prueba de la tuberculina indica la existencia de transmisión en el colegio. Esta investigación refuerza la idea de llevar a cabo un amplio estudio de contactos en centros escolares ante la detección de un caso de tuberculis, sea bacilífero o no.</p>"
]
"en" => array:2 [
"titulo" => "Abstract"
"resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Outbreaks of microepidemics of tuberculosis indicate the existence of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> transmission. We describe a microepidemic in a school in which an index case with low infective capacity gave rise to a high percentage of tuberculosis infection and disease in the center.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Contact investigation was performed in 423 pupils of a school after a recently arrived teacher with few symptoms was diagnosed with tuberculosis. A cross-sectional study was carried out to calculate the prevalence of tuberculosis infection and disease in the school center.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Statistically significant differences were found in the distribution of positive results in the first tuberculosis skin test for primary and secondary students, with more positive results in secondary school pupils (18.4%) than in primary school pupils (6.1%). The incidence of skin tuberculosis test converters was 5.7%. The prevalence of infection by educational level was 10% in primary education and 23.4% in secondary education. The risk of infection in secondary school pupils was more than twice that in primary school pupils (OR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.4; 95% CI, 1.5-3.5). There were 6 new cases of tuberculosis in pupils.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">The high percentage of conversions in the second tuberculosis skin test indicated the existence of transmission in the school. The results of this study support contact investigation in schools where there is exposure to a case of tuberculosis, whether highly infective or nort.</p>"
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"identificador" => "bib1"
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"referenciaCompleta" => "Comunidad de Madrid. Informe del Registro de Casos de Tuberculosis 2002. Boletín Epidemiológico de la Comunidad de Madrid. 2002;10:4-34."
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0 => "J.L. Calpe"
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0 => "P. De March"
1 => "M.A. Boqué"
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0 => "E. Bernaola"
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0 => "A. Salazar"
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"titulo" => "Microepidemias escolares de tuberculosis. A propósito de 13 casos recogidos en la provincia de Barcelona"
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"etal" => false
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1 => "P. De March"
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"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Descripción de una microepidemia escolar de tuberculosis"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:6 [
0 => "J.M. Querol"
1 => "C. Oltra"
2 => "J. Mínguez"
3 => "R. Moreno"
4 => "E. Sánchez"
5 => "P. Martínez"
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"tituloSerie" => "Enferm Infecc Microbiol Clin"
"fecha" => "1993"
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"url" => "https://www.ncbi.nlm.nih.gov/pubmed/8324025"
"web" => "Medline"
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0 => array:2 [
"titulo" => "Control and prevention of tuberculosis in the United Kingdom: code of Practice 2000"
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"colaboracion" => "Joint Tuberculosis Committee of the British Thoracic Society"
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