Document 0094
 DOCN  M9610094
 TI    [Tuberculosis: current epidemiological-clinical problems]
 DT    9601
 AU    Demedts M; Van den Brande P; Gyselen A; Dienst Longziekten U.Z.
       Gasthuisberg Katholieke Universiteit; Leuven.
 SO    Verh K Acad Geneeskd Belg. 1995;57(2):81-103; discussion 103-8. Unique
       Identifier : AIDSLINE MED/96012832
 AB    Tuberculosis (tb) mortality, morbidity and infection prevalence were
       very high in Belgium and in the other industrialised countries during
       the previous century, and the first half of this century. Therefore tb
       was an export pathology, especially towards developing countries. At the
       end of this century tb-epidemiological indices reached very low levels
       in the Western world, while tb became endemic in several non-Western
       countries and so it actually has become an import pathology. In the USA,
       as well as in many European countries, the tb-morbidity incidence
       started to increase again about ten years ago. The risk groups are,
       however, not identical in the USA and in Belgium. In the USA, it is
       particularly the AIDS-epidemic that is the cause of half of the increase
       in tb-incidence; in addition social outcasts, homeless and IV-drug
       addicts are important risk groups and due to their poor therapy
       compliance they are responsible for the many multidrug resistant forms
       emerging in New York and other large cities. In Belgium elderly males
       are an important risk group with a tb-incidence of 50 per 10(5) in 1993
       (versus an overall incidence of 15 per 10(5)). Besides, in this group
       the diagnosis is often made late. A second important risk group consists
       of allochthones, with an incidence of 54 per 10(5), especially
       non-Western allochthones, with an incidence of 120 per 10(5). Above all
       others are the asylum seekers with an estimated incidence of 400 per
       10(5) (which undoubtedly is an underestimation). In Belgium, the
       AIDS-epidemic does not represent a major problem so far; only 3.5% of
       the tb-cases have AIDS or are HIV-positive, and 50% of these are
       immigrants. Finally, also multidrug resistance is no real problem, since
       resistance against isoniazide and rifampicin has been found in only 0.5%
       of the tb-cases. Contact persons of tb-cases, however, still remain a
       very important risk group with an incidence of more than 200 per 10(5).
       The danger is especially great for as long as the diagnosis has not been
       made in the source of infection and no therapeutic measures have been
       taken. While the overall tb-threat increased in the last decade, the
       tb-organisations (in Flanders the VRGT, Vereniging voor Respiratoire
       Gezondheidszorg en Tuberculosebestrijding) have been more or less
       dismantled, which in consequence may lead to problems in the
       future!(ABSTRACT TRUNCATED AT 400 WORDS)
 DE    Adult  Aged  AIDS-Related Opportunistic Infections/EPIDEMIOLOGY
       Belgium/EPIDEMIOLOGY  Emigration and Immigration  English Abstract
       Female  Human  Incidence  Male  Middle Age  Prevalence  Refugees  Risk
       Factors  Tuberculosis/*EPIDEMIOLOGY/*PREVENTION & CONTROL  United
       States/EPIDEMIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).