Salvato in:
| Autore principale: | |
|---|---|
| Natura: | Artículo científico |
| Lingua: | en |
| Pubblicazione: |
Medical Education Cooperation with Cuba
2011
|
| Soggetti: | |
| Accesso online: | https://www.redalyc.org/articulo.oa?id=437542079006 |
| Tags: |
Aggiungi Tag
Nessun Tag, puoi essere il primo ad aggiungerne!!
|
Sommario:
- Cuba’s Strategy for Childhood Tuberculosis Control, 1995–2005 Gladys Abreu José A. González Edilberto González Ileana Bouza Antonio Velázquez Tomás Pérez Ruth Rubán Miriam González Reinaldo Sánchez Roberto Muñoz Lizet Sánchez Medicina Cuba therapy diagnosis mortality Tuberculosis INTRODUCTION Following a tripling of tuberculosis incidence inCuba between 1991 and 1994 (from 4.7 to 14.7 per 100,000), theNational TB Control Program was revamped in 1995 and the NationalReference Center for Childhood TB and Provincial Childhood TBCommissions were created as a strategy for addressing this emerginghealth problem.OBJECTIVE Assess the impact of Cuba’s new strategy for TB controlin children aged <15 years during the period 1995–2005.METHODS A descriptive review of health services and systems wasconducted in Cuba, examining 157 cases of TB diagnosed in childrenaged <15 years during the period 1995–2005 and comparingimpact and process indicators for selected years (1995, 2000, and2005). Impact indicators included reduction in: a) incidence; b) seriousforms (peritoneal, meningeal, miliary, combined); c) mortality; and d)case outcomes (cure, death, treatment drop-out, treatment failure).Process indicators were proportion of cases with: a) microbiologicaltests; b) knowledge of infection source; c) diagnoses obtained throughadult case contact tracing; d) time to diagnosis <60 days; and e) postmortemdiagnoses.RESULTS During the period 1995–2005, TB rates in children aged<15 years fell by 50% (from 1.0 to 0.5 per 100,000), more evidentin children <10 years. The Havana rate was three times the nationalrate. Diagnosis was post-mortem in three serious cases (1.9%); therewere four deaths (2.5%), none after 2000. Only seven children (4.5%)had serious forms, none after 2002. Except for cases diagnosed postmortem,all children received treatment directly supervised by healthpersonnel. Cure rate was 99.4%; there were no treatment drop-outs orchronic cases; one relapse was reported (0.6%). Knowledge of infectionsource increased to 90% over the selected years. Microbiologicaltests were conducted in 90% of cases, with isolation in 30.9%. No isolatewas drug-resistant, nor were there reports of infectious contactswith resistance. We found no HIV coinfection. At the end of the study,time to diagnosis of ≥60 days persisted in 40% of cases.CONCLUSIONS Creation of a National Reference Center for ChildhoodTB and Provincial Childhood TB Commissions has contributedto improved TB diagnosis and control in children aged <15 years,achieving incidence similar to that during the period prior to TB reemergenceand to those of some developed countries. Improvementsare needed in the work and systematic training of health personnel,especially at the primary health care level, in order to eliminate TB asa national health problem by 2015. 2011 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542079006 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.3 Vol.13