[The evolution of pulmonary tuberculosis in health area no 4 in Valencia during the period 1988-1993]

Morbidity from Pulmonary tuberculosis, detected by the system EDO in the Autonomous Community of Valencia, shows an increasing trend and differential behaviour in relation with age and constitutes, with no doubt, a Public Health problem involving a joint action of multiple clinical care and preventive units.

In our study, the cases of notified and confirmed pulmonary tuberculosis over the period 1988-1993 in the Health Area number 4 (Region Camp de Morvedre 167.744 inhabitants) are analyzed by estimating the evolution of incidence, the diagnosis time and place where this diagnosis was made in accordance with the conventional variables of ecological studies and excluding from our registry the cases of those patients with co-infection by virus VIH.

The growing evolution of incidence, the mean rate for the period (49.95.10(5) h.), the rate differential per age-groups during the period and the concentration of cases in the young age-groups (15-39 years) constitute, together with the diagnosis time (75.6 days in Primary Health Care; 74.3 in Hospital), the most outstanding results. Nevertheless, the prolongation of the diagnosis time for order age-groups (140-168 days in people older than 54 years) and the absence of a previous known contact, suggest the presence of undetected cases of TBC and dissemination ways other than the interfamily ones.

An improved notification and identification of cases from hospital sources involves the necessity of reducing the mean diagnosis time and the research on the ways of transmission other than the interfamily ones; this explains a limited part of the incidence.