Skip to main content

Free Content Changes in the geographical distribution of tuberculosis patients in Veracruz, Mexico, after reinforcement of a tuberculosis control programme

Download Article:

You have access to the full text article on a website external to ingentaconnect.

Please click here to view this article on Wiley Online Library.

You may be required to register and activate access on Wiley Online Library before you can obtain the full text. If you have any queries please visit Wiley Online Library

Abstract:

Summary Objective 

Geographical information systems are valuable tools for studying tuberculosis (TB) epidemiology, but have been underused for the evaluation of TB control programs. We aimed to compare the geographical distribution of TB before and after the five elements of directly observed therapy, short course (DOTS) were strengthened in a Health Jurisdiction in Mexico in response to recommendations made by the WHO Global Tuberculosis Program. Methods 

All consenting persons detected by passive case finding between March 1995 and February 2000 who were confirmed to have acid-fast bacilli (AFB) in sputum underwent clinical and laboratory evaluation. A TB ‘episode’ was defined as the period of time between bacteriological diagnosis and treatment discharge by the local control programme. Distances of TB episodes from the nearest urban centre were determined according to recent transmission and multidrug resistance (MDR). Results 

During the first half of the study period, MDR episodes were located a median distance of 1.24 km from urban centres, which did not differ significantly from non-MDR episodes (1.14 km, P = 0.56). In contrast, the median distance of MDR episodes increased 55% to 1.92 km during the second half, which placed them significantly further away out than non-MDR episodes (1.08 km, P = 0.01). No changes in location were detected for recent transmission. Conclusion 

While reinforcing the TB control programme reduced the incidence of MDR, the remaining episodes were located in poorer and more remote areas.

Keywords: Geographical Information Systems; Mexico; directly observed therapy; multidrug-resistant; tuberculosis

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2005.01392.x

Affiliations: 1: Stanford University, Palo Alto, CA, USA 2: Instituto Nacional de Salud Pública, México, Cuernavaca, México 3: Instituto Nacional de Ciencias Médicas y Nutrición ‘Salvador Zubirán’, México D.F., México

Publication date: April 1, 2005

bsc/tmih/2005/00000010/00000004/art00004
dcterms_title,dcterms_description,pub_keyword
6
5
20
40
5

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more