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La tasa de infección comunitaria como indicador para el control de la tuberculosis
G Madico1, R H Gilman, W Checkley
1AB Prisma, Lima, Peru.
Lancet (London, England)
|February 18, 1995
Resumen
La transmisión de la tuberculosis en los barrios marginales peruanos a menudo se basa en la comunidad, no solo dentro de los hogares. Este hallazgo sugiere que las estrategias actuales de control de la tuberculosis pueden necesitar adaptación para entornos comunitarios de alta transmisión.
Área de la Ciencia:
- Epidemiología La epidemiología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Salud Pública La salud pública.
Sus antecedentes:
- La epidemiología de la tuberculosis (TB) requiere una mayor comprensión, en particular la dinámica de transmisión en poblaciones vulnerables.
- Investigar el equilibrio entre la propagación en el hogar y en la comunidad es crucial para un control efectivo de la TB.
Objetivo del estudio:
- Determinar la importancia relativa de la transmisión dentro del hogar frente a la transmisión comunitaria de Mycobacterium tuberculosis en niños.
- Para evaluar los factores de riesgo para la infección por tuberculosis en un entorno de barrios marginales peruanos.
Principales métodos:
- Un estudio transversal que involucró a 175 niños de hogares infectados con tuberculosis (contactos) y 382 niños de hogares no infectados (controles).
- La prevalencia de la exposición a Mycobacterium tuberculosis se midió utilizando la prueba cutánea de derivados de proteínas purificadas (PPD).
- La tasa de infección comunitaria (CIR) se calculó para diferenciar las fuentes de transmisión.
Principales resultados:
- El 55% de los niños de contacto y el 34% de los niños de control dieron positivo en PPD.
- Vivir en un hogar de contacto y el aumento de la edad fueron factores de riesgo significativos para la positividad de PPD.
- El coeficiente de probabilidad ajustado indicó una mayor probabilidad de transmisión comunitaria en este entorno en comparación con otros estudios.
Conclusiones:
- El estudio pone de relieve la transmisión comunitaria significativa de la tuberculosis en las barriadas peruanas estudiadas.
- Las estrategias actuales de control de la TB, centradas principalmente en los contactos domésticos, pueden ser insuficientes para las áreas con alta transmisión comunitaria.
- Se necesitan intervenciones de salud pública adaptadas para abordar la propagación de la TB fuera del hogar.
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