BACKGROUND: To analyze clinical practice regarding tuberculosis in Spain. MATERIAL AND METHOD: After active search in 14 registries, cases of tuberculosis were identified in 13 autonomous regions, representing almost 67% of the total Spanish population. The study period was May 1996-April 1997. RESULTS: 10,053 cases were identified. Almost 80% were diagnosed at the hospital and most of the patients (91.7%) were symptomatic. Median patient delay was 21 days and median delay between symptoms and treatment was 41 days. Smear and culture was performed in 82% of pulmonary cases while at least a culture was performed in 75.5% of extrapulmonary cases. 72.5% of pulmonary cases and 39.7% of extrapulmonary cases were culture positive. More than 76% of the subjects were treated with 3 drugs, generally rifampin, isoniazid and pirazinamide in agreement with Spanish guidelines; however, the information on duration of treatment was insuficient. Combined tablets were usually prescribed (86.8% of patients) and use of DOT was scarce (5.4% of cases). The information on contact investigation was poor. CONCLUSIONS: Diagnostic and treatment practices regarding tuberculosis have clearly improved in Spain, but patient management has still to improve.
BACKGROUND: To analyze clinical practice regarding tuberculosis in Spain. MATERIAL AND METHOD: After active search in 14 registries, cases of tuberculosis were identified in 13 autonomous regions, representing almost 67% of the total Spanish population. The study period was May 1996-April 1997. RESULTS: 10,053 cases were identified. Almost 80% were diagnosed at the hospital and most of the patients (91.7%) were symptomatic. Median patient delay was 21 days and median delay between symptoms and treatment was 41 days. Smear and culture was performed in 82% of pulmonary cases while at least a culture was performed in 75.5% of extrapulmonary cases. 72.5% of pulmonary cases and 39.7% of extrapulmonary cases were culture positive. More than 76% of the subjects were treated with 3 drugs, generally rifampin, isoniazid and pirazinamide in agreement with Spanish guidelines; however, the information on duration of treatment was insuficient. Combined tablets were usually prescribed (86.8% of patients) and use of DOT was scarce (5.4% of cases). The information on contact investigation was poor. CONCLUSIONS: Diagnostic and treatment practices regarding tuberculosis have clearly improved in Spain, but patient management has still to improve.