[Measles outbreak in a socially deprived area of the province of Seville, Spain]. / Análisis de un brote de sarampión en una barriada de la provincia de Sevilla, España.

BACKGROUND: In 2011 in Seville (Spain), measles outbreak affected 1759 people. It began in the neighbourhood of Santa Isabel (city San Juan de Aznalfarache), where Roma community resides. We described the outbreak epidemiologically and calculated the risk of disease in the population. METHOD: Descriptive study of outbreak and cohort study. Exposed population was considered to Barriada resident and not exposed to the rest of the municipality. The data sources were: the Institute of Statistics of Andalusia, the social services of San Juan´s town and the Epidemiological Surveillance System of Andalusia. We described the outbreak and incidences were calculated and Relative Risk. The cases were confirmed by clinical, laboratory and/or epidemiological. RESULTS: In the neighbourhood the cases were concentrated among the group between 2 and 19 years, while in the rest of the town occurred in children under 2 and over 19 years. The overall incidence of the outbreak was 0,98 per 1.000 inhabitants, 4,94 in San Juan; from 23,15 in the exposed, 2,1 in the unexposed and in the group of 2-19 years 89,58 in the neighbourhood and 5,33 in the rest on the town. CONCLUSIONS: The outbreak affected more children under 20 years old, unvaccinated and residents in the neighborhood Santa Isabel. The risk of falling ill with measles in the neighbourhood was 11 and 17 in the group between 2 and 19 years. We need to develop strategies to reduce health inequalities that accompany some outbreaks.

Análisis de un brote de sarampión en una barriada de la provincia de Sevilla, España / Measles outbreak in a socially deprived area of the province of Seville, Spain

Fundamentos: En 2011 en Sevilla (España) un brote de Sarampión afectó a 1.759 personas. Comenzó en la Barriada de Santa Isabel, San Juan de Aznalfarache (Sevilla), donde reside una comunidad Romaní. El objetivo del trabajo es describir epidemiologicamente el brote en la localidad y calcular el riesgo de enfermar por sarampión de los residentes en la barriada Santa Isabel. Método: Se diseñó un estudio de cohortes retrospectivo. Se consideró población expuesta a los residentes en la barriada de Santa Isabel y no expuesta a la del resto del municipio. Las fuentes de datos fueron: el Instituto de Estadística de Andalucía, el Ayuntamiento del municipio y el Sistema de Vigilancia Epidemiológica de Andalucía. Se describió el brote y se calcularon incidencias y el Riesgo Relativo. Los casos fueron confirmados por criterios clínicos, de laboratorio y/o epidemiológicos. Resultados: En la barriada los casos se concentraron entre el colectivo etario de entre 2 y 19 años, mientras que en el resto de la localidad se produjo en menores de 2 y mayores de 19 años. La incidencia global del brote fue de 0,98 por 1.000 habitantes. En San Juan de 4,94 . Entre los expuestos fue de 23,15 y de 2,1 en los no expuestos. En el colectivo de 2 a 19 años la incidencia fue 89,58 por 1.000 habitantes en la Barriada y de 5,33 por 1.000 habitantes en el resto de la localidad. Conclusiones: El brote afectó en mayor medida a menores de 20 años, a población no vacunada y residente en la Barriada Santa Isabel. El riesgo de enfermar de Sarampión en la Barriada fue de 11 y de 17 en el colectivo entre 2 y 19 años. Precisamos elaborar estrategias que reduzcan las desigualdades en salud que acompañan a algunos brotes epidémicos(AU)

Background: In 2011 in Seville (Spain), measles outbreak affected 1759 people. It began in the neighbourhood of Santa Isabel (city San Juan deAznalfarache), where Roma community resides. We described the outbreak epidemiologically and calculated the risk of disease in the population. Method: Descriptive study of outbreak and cohort study. Exposed population was considered to Barriada resident and not exposed to the rest of the municipality. The data sourceswere: the Institute of Statistics ofAndalusia, the social services of San Juan’s town and the Epidemiological Surveillance System ofAndalusia.We described the outbreak and incidences were calculated and Relative Risk. The cases were confirmed by clinical, laboratory and /or epidemiological. Results: In the neighbourhood the cases were concentrated among the group between 2 and 19 years, while in the rest of the town occurred in children under 2 and over 19 years. The overall incidence of the outbreak was 0,98 per 1.000 inhabitants, 4,94 in San Juan; from 23,15 in the exposed, 2,1 in the unexposed and in the group of 2-19 years 89,58 in the neighbourhood and 5,33 in the rest on the town. Conclusions: The outbreak affected more children under 20 years old, unvaccinated and residents in the neighborhood Santa Isabel. The risk of falling ill with measles in the neighbourhood was 11 and 17 in the group between 2 and 19 years.We need to develop strategies to reduce health inequalities that accompany some outbreaks(AU)

[Evaluation of a strategy for the control of tuberculosis in a health district of andalusia, Spain]. / Evaluación de una estrategia para el control de la tuberculosis en un distrito sanitario de Andalucía.

BACKGROUND: Tuberculosis in Spain and Andalusia, the incidence rates above those of surrounding countries. Many authors emphasize the need for improved epidemiological information, the organization of health services and social support to patients. The aim of this study was to evaluate the results obtained after developing a strategy involving the three elements outlined in the Primary Care District of Andalusia. METHODS: We followed up to 234 TB patients residing in the District and reported to the Epidemiological Surveillance System of Andalusia during the period 2004-2008. Were considered as indicators for evaluating the percentage of patients who completed treatment, the percentage of smear-positive contacts with study, new cases detected in the same and the incidence in children under 15 years. RESULTS: Of the 234 patients were followed up cash 95% of them completed treatment 182 (78%) died 18, moved from home, 10 and 12 still remained in treatment. Of the 130 cases that presented positive sputum studied 112 contacts (86%). 27 new cases were detected among the contacts studied, and the annual incidence in children under 15 years was 6.65 per 100,000 population. Tracking losses were reduced by 30%, and terminations of treatment and contact studies improved by 25% and 30% respectively compared to data from the whole of Andalusia. CONCLUSIONS: The strategy has helped improve the proposed assessment indicators. The% of new cases detected in studies of contacts and the annual incidence in children under 15 years was similar in this study than in Andalusia.

Evaluación de una estrategia para el control de la tuberculosis en un distrito sanitario de Andalucía / Evaluation of a strategy for the control of tuberculosis in a health district of Andalusia, Spain

Fundamento: La tuberculosis en España y Andalucía presenta tasas de incidencia por encima de las de países de nuestro entorno. Muchos autores señalan la necesidad de mejorar la información epidemiológica, la organización de los servicios sanitarios y el apoyo social a los pacientes. El objetivo de este trabajo es evaluar los resultados de una estrategia que contemplaba los tres elementos reseñados en un Distrito de Atención Primaria de Andalucía.Métodos: Se realizó el seguimiento a 234 enfermos de tuberculosis residentes en el Distrito y notificados al Sistema de Vigilancia Epidemiológica de Andalucía durante el período 2004-2008. Se consideraron como indicadores de evaluación el porcentaje que finalizó el tratamiento, el porcentaje de pacientes bacilíferos con estudio de contactos, los nuevos casos detectados en los mismos y la incidencia en menores de 15 años.Resultados:.De los 234 pacientes incluidos se realizó un seguimiento efectivo en el 95%, de ellos finalizaron el tratamiento 182 (78%), fallecieron 18, se trasladaron de domicilio 10 y continuaban aún en tratamiento12. De los 130 casos que presentaron baciloscopia positiva se estudiaron a los contactos de 112 (el 86%). Se detectaron 27 nuevos casos entre los contactos estudiados y la incidencia anual en menores de 15 años fue del 6.65 por 100.000. Las perdidas del seguimiento se redujeron un 30% y las finalizaciones del tratamiento y los estudios de contactos mejoraron un 25% y 30% respectivamente, respecto a los datos del conjunto de Andalucía.Conclusiones: La estrategia seguida ha permitido mejorar los indicadores de evaluación propuestos. El % de casos nuevos detectados en los estudios de contactos y la incidencia anual en menores de 15 años ha sido similar en este estudio que en Andalucía(AU)

Background: Tuberculosis in Spain and Andalusia, the incidence rates above those of surrounding countries. Many authors emphasize the need for improved epidemiological information, the organization of health services and social support to patients. The aim of this study was to evaluate the results obtained after developing a strategy involving the three elements outlined in the Primary Care District of Andalusia.Methods: We followed up to 234 TB patients residing in the District and reported to the Epidemiological Surveillance System of Andalusia during the period 2004-2008. Were considered as indicators for evaluating the percentage of patients who completed treatment, the percentage of smear-positive contacts with study, new cases detected in the same and the incidence in children under 15 years.Results:. Of the 234 patients were followed up cash 95% of them completed treatment 182 (78%) died 18, moved from home, 10 and 12 still remained in treatment. Of the 130 cases that presented positive sputum studied 112 contacts (86%). 27 new cases were detected among the contacts studied, and the annual incidence in children under 15 years was 6.65 per 100,000 population. Tracking losses were reduced by 30%, and terminations of treatment and contact studies improved by 25% and 30% respectively compared to data from the whole of Andalusia.Conclusions: The strategy has helped improve the proposed assessment indicators. The% of new cases detected in studies of contacts and the annual incidence in children under 15 years was similar in this study than in Andalusia(AU)