Incidence of Pulmonary Tuberculosis and HIV Coinfection in the Province of Seville, Spain, 1998

• Published in: European journal of epidemiology Vol. 17; no. 8; pp. 737 - 742
• Main Authors: J. M. Mayoral Cortés, Fernández, M. García, M. C. Varela Santos, J. C. Fernández Merino, León, J. García, Guibert, D. Herrera, Navarro, F. Martínez
• Format: Journal Article
• Language: English
• Published: Dordrecht Kluwer Academic Publishers 01.01.2001; Springer; Springer Nature B.V
• Subjects: Age groups; AIDS-Related Opportunistic Infections - epidemiology; Biological and medical sciences; Coinfection; Disease; Epidemiology; Estimation methods; Female; Health surveillance; HIV; Hospitals; Human viral diseases; Humans; Incidence; Infectious diseases; Male; Medical sciences; Notifiable diseases; Population Surveillance; Predictive Value of Tests; Public health; Pulmonary tuberculosis; Sensitivity and Specificity; Spain - epidemiology; Surveillance; Tuberculosis; Tuberculosis, Pulmonary - epidemiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young adults; Europe; Spain; Human; Immunopathology; Lung disease; Respiratory disease; Lung; Retroviridae; AIDS; Mycobacterial infection; Immune deficiency; Lentivirus; Epidemiology; Incidence; Infection; Virus; Concomitant disease; Tuberculosis; Mycobacterium tuberculosis; Mycobacteriales; Viral disease; Bacteriosis; Mycobacteriaceae; Bacteria; Actinomycetes; Human immunodeficiency virus
• ISSN: 0393-2990; 1573-7284
• DOI: 10.1023/A:1015632013465

Using the National Notifiable Disease Surveillance System (NNDSS) and Minimum Basic Data Set (MBDS) for hospital discharges we evaluated pulmonary tuberculosis (PTB) surveillance and estimated real PTB incidence and human immuno-deficiency virus (HIV) coinfection in Seville in 1998. In addition, we assessed the sensitivity and the positive predictive value (PPV) of the surveillance system. Real incidence of pulmonary tuberculosis was estimated by the capture-recapture method. In 1998, the province of Seville reported 225 cases of pulmonary tuberculosis to the NNDSS, an incidence of 13.2 per 100,000 population. Of the 225 cases reported, 18.2% presented with HIV coinfection, while a total of 194 had confirmed diagnoses. The MBDS accounted for 106 new cases. Of these, 24.8% presented with HIV coinfection and were 58% less likely to be reported to the NNDSS (25-76%, p = 0.001). Applying the capture-recapture method, 426 cases were estimated, an overall incidence of 25.6 per 100,000 population (21.5-28.8). Completeness for each source was similar (47%), and for both jointly was 72.7%. The NNDSS had a sensitivity of 65.3% and a PPV of 89.3%. In conclusion, the NNDSS underestimates PTB and PTB-HIV coinfection in Seville. The high incidence observed in young adults suggests a high degree of tuberculosis endemicity. Hospital records provide a readily accessible, low-cost means of estimating disease incidence.