Brote de tuberculosis resistente a isoniacida en una comunidad de inmigrantes en España / Outbreak of isoniazid-resistant tuberculosis in an immigrant community in Spain

Introducción: La tuberculosis (TB) continúa siendo un importante problema de salud pública. En 2013 se declararon 9 millones de casos nuevos de TB activa a nivel mundial, siendo la proporción de nuevos casos de TB multirresistente del 3,5%. Método: Se realizó un estudio de contactos de un caso de TB pulmonar en una paciente de nacionalidad boliviana. Las pruebas diagnósticas se realizaron según los protocolos establecidos a nivel nacional y local. Resultados: Se detectaron 5 casos a partir del caso índice y se constató la existencia de un brote de TB en una comunidad inmigrante. El resultado del genotipado y del antibiograma ampliado de las muestras de esputo fue crecimiento de Mycobacterium tuberculosis (KatG-msp no mutado/inhA C-T 5RBS) resistente a isoniacida. Se realizó la búsqueda activa de convivientes y contactos con un censo total de 39 personas. La incidencia de infección latente fue de 71,43%. Discusión: El estudio de este brote como otros en la literatura constata la importancia de la búsqueda activa de la localización de contactos y su estudio, de la investigación de laboratorio para lograr la mejora en la detección precoz de la TB. Un diagnóstico precoz del enfermo, el cumplimiento de un tratamiento adecuado y la vigilancia de la farmacorresistencia se consideran pilares fundamentales para la prevención y el control de la TB

Background: Tuberculosis (TB) remains a major public health problem. In 2013, 9 million new cases of active TB were estimated globally and the proportion of reported new cases with multi-drug resistance (MDR) was 3.5%. Methods: Contact tracing of a case of pulmonary tuberculosis was performed in a Bolivian patient. Diagnostic tests were performed according to national and local protocols. Results: An outbreak of tuberculosis in an immigrant community was detected, with 5 cases originating from one index case. Genotyping and drug susceptibility testing of the sputum samples determined Mycobacterium tuberculosis resistant to isoniazid (KatG-msp unmutated/inhA 5RBS CT). Active case finding revealed a total of 39 contacts with an incidence of latent infection of 71.43%. Conclusions: The present study confirms the importance of active case finding through contact tracing as well as rapid laboratory diagnosis to achieve improvements in early detection of TB. Early diagnosis of the patient, compliance with appropriate treatment protocols and monitoring of drug resistance are considered essential for the prevention and control of TB

Outbreak of isoniazid-resistant tuberculosis in an immigrant community in Spain. / Brote de tuberculosis resistente a isoniacida en una comunidad de inmigrantes en España.

BACKGROUND: Tuberculosis (TB) remains a major public health problem. In 2013, 9 million new cases of active TB were estimated globally and the proportion of reported new cases with multi-drug resistance (MDR) was 3.5%. METHODS: Contact tracing of a case of pulmonary tuberculosis was performed in a Bolivian patient. Diagnostic tests were performed according to national and local protocols. RESULTS: An outbreak of tuberculosis in an immigrant community was detected, with 5 cases originating from one index case. Genotyping and drug susceptibility testing of the sputum samples determined Mycobacterium tuberculosis resistant to isoniazid (KatG-msp unmutated/inhA 5RBS CT). Active case finding revealed a total of 39 contacts with an incidence of latent infection of 71.43%. CONCLUSIONS: The present study confirms the importance of active case finding through contact tracing as well as rapid laboratory diagnosis to achieve improvements in early detection of TB. Early diagnosis of the patient, compliance with appropriate treatment protocols and monitoring of drug resistance are considered essential for the prevention and control of TB.

Developing countries: health round-trip.

International travel can pose various risks to health, depending both on the health needs of the traveller and on the type of travel to be undertaken. Travellers intending to visit a destination in a developing country should consult a travel medicine clinic or medical practitioner before the journey. General precautions can greatly reduce the risk of exposure to infectious agents. Vaccination is a highly effective method of preventing certain infectious diseases. The aim of this study is to know the risks involved and the best way to prevent them.

Malaria in developing countries.

Malaria still poses a real threat to travellers, particularly in areas with high transmission rates such as sub-Saharan Africa, Papua New Guinea, and the South Pacific islands. Malaria causes an estimated 660,000 deaths each year from 219 million cases of illness. It is a preventable and curable disease. Malaria symptoms appear after a period of seven days or longer, and without treatment, the disease can lead to death. Mosquito bite prevention is the main way to reduce malaria transmission. Chemoprophylaxis recommendations depend on travelers' age, destination, type of travelling, or length of stay. Pregnant women, children, and immunosuppressed travelers are the most susceptible. There are currently no licensed vaccines against malaria. Results about a research vaccine candidate known as RTS,S/AS01 are expected in 2015.