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1996-01-30
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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).