TY - JOUR
T1 - The dynamics of pulmonary tuberculosis in Colima, Mexico (1999-2002)
AU - Chowell, Gerardo
AU - Diaz-Dueñas, Porfirio
AU - Chowell, Diego
N1 - Funding Information:
We thank an anonymous reviewer for providing useful comments that helped improve this manuscript. G. Chowell is supported by a Director’s postdoctoral fellowship from Los Alamos National Laboratory.
PY - 2005/11
Y1 - 2005/11
N2 - Tuberculosis is a public health problem in Mexico. From 1999 to 2002, we assessed retrospectively the epidemiological, clinical, and treatment characteristics of pulmonary tuberculosis in the hospitals of the Mexican Institute of Public Health in the state of Colima (Mexico). We included 184 cases diagnosed with pulmonary tuberculosis. A database containing demographic, epidemiological, and clinical information was constructed and analyzed. We estimate a median patient delay of 83 d and a mean treatment delay of 2.3 d. Of 14 cases suspected for multiresistance and microbiologically assayed, 5 were found to carry a multi-drug-resistant strain. We also found a significant association between a short patient delay and the presence of hemoptysis (p=0.002) or dyspnea (p>0.001). 86 patients (46.8%) were sputum smear microscopy negative at the end of treatment and 40 (21.7%) completed treatment giving an overall success rate of 68.5%, which compares unfavorably with the World Health Organization target success rate of 85%. Five (2.7%) patients failed treatment, 10 (5.4%) died, 39 (21.2%) interrupted treatment, and 4 (2.2%) transferred to another reporting unit. A 2002 strategic change in drug distribution seemed to prove successful.
AB - Tuberculosis is a public health problem in Mexico. From 1999 to 2002, we assessed retrospectively the epidemiological, clinical, and treatment characteristics of pulmonary tuberculosis in the hospitals of the Mexican Institute of Public Health in the state of Colima (Mexico). We included 184 cases diagnosed with pulmonary tuberculosis. A database containing demographic, epidemiological, and clinical information was constructed and analyzed. We estimate a median patient delay of 83 d and a mean treatment delay of 2.3 d. Of 14 cases suspected for multiresistance and microbiologically assayed, 5 were found to carry a multi-drug-resistant strain. We also found a significant association between a short patient delay and the presence of hemoptysis (p=0.002) or dyspnea (p>0.001). 86 patients (46.8%) were sputum smear microscopy negative at the end of treatment and 40 (21.7%) completed treatment giving an overall success rate of 68.5%, which compares unfavorably with the World Health Organization target success rate of 85%. Five (2.7%) patients failed treatment, 10 (5.4%) died, 39 (21.2%) interrupted treatment, and 4 (2.2%) transferred to another reporting unit. A 2002 strategic change in drug distribution seemed to prove successful.
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U2 - 10.1080/00365540500348911
DO - 10.1080/00365540500348911
M3 - Article
C2 - 16308221
AN - SCOPUS:30544452460
SN - 0036-5548
VL - 37
SP - 858
EP - 862
JO - Scandinavian Journal of Infectious Diseases
JF - Scandinavian Journal of Infectious Diseases
IS - 11-12
ER -