[Active epidemiologic surveillance of tuberculosis]

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Context:

• Tuberculosis (TB) is Chile's most significant communicable disease, with 5,000 annual cases.
• Control programs require effective surveillance linked to infection, morbidity, and mortality data.
• A downward trend in TB cases (66/100,000 in 1982 to 37/100,000 in 1992) was observed.

Purpose:

• To highlight the need for an effective tuberculosis surveillance system in Chile.
• To analyze the advantages and disadvantages of current tuberculosis control programs.
• To identify key indicators for evaluating tuberculosis control effectiveness beyond classical metrics.

Summary:

• Despite a national downward trend in tuberculosis cases, Santiago experienced a 4% rise in morbidity and a 37% rise in mortality between 1991 and 1992.
• Morbidity rates vary regionally, with the highest in the I Region of Tarapacá, potentially linked to ethnic factors.
• Tuberculosis deaths result from both recent active disease (75%) and long-term effects (25%), with individuals over 55 comprising 25% of new cases.

Impact:

• Emphasizes the need to analyze diverse indicators, including laboratory test results, antibiotic resistance, treatment outcomes, infection factors, BCG immunization efficacy, zoonotic TB, treatment delays, high-risk screening, and mortality reviews.
• Suggests that localized increases in tuberculosis necessitate targeted interventions and reassessment of control strategies.
• Highlights the importance of considering age and regional variations in tuberculosis epidemiology for effective public health planning.