[Use of pyrazinamide as an indicator of tuberculosis epidemiology in Castilla-La Mancha]

To describe the use of tuberculostatic drugs in Castilla-La Mancha Spanish region along the 1999-2000 period; to estimate the number of persons who received tuberculosis treatment in 1999 and 2000; and to compare the results with the case reporting data.

The pyrazinamide use data in Castilla-La Mancha along the 1999-2000 period were obtained from the Spanish Health Ministry. The defined daily dose and the daily dose per inhabitant were used as measures for comparison. The number of persons who had received treatment was calculated and this figure was compared with the case reporting of tuberculosis respiratory, tuberculosis, other types and tuberculous meningitis.

The incidence of registered tuberculosis cases was 192 and 182 cases in 1999 and 2000, respectively, with rates of 11.07 and 10.49 cases per 100,000 population. In 1999 and 2000, 388 and 389 people (22.41 and 22.43 cases per 100,000 population) received treatment with pyrazinamide in Castilla-La Mancha, respectively, which suggests that the rate of registered tuberculosis can show an underreporting of 50%.

An important tuberculosis underreporting is detected, with large differences between the different provinces. Pyrazinamide use is probably the better indicator to estimate the minimum incidence of tuberculosis.