Tuberculosis at the local level: Marianao Municipality, Havana City, Cuba (1990-2000)

Abstract

Background: For the elimination of tuberculosis (TB) is necessary the surveillance of the incidence rate at the local level, as this is the first level of access to the health service. This study is aimed at providing a description of the spread and trend of the tuberculosis incidence rates in Marianao Municipality, Habana City by healthcare areas and age groups throughout the 1990-2000 period. Methods: The time series for the 1990-1994 and 1995-2000 incidence rates were analyzed employing a two parameter exponential smoothing method. The total percentage and annual average of variation was estimated. The healthcare areas were stratified. Results: In 1990 - 1994, the rate rose from 11.1 to 25.8 per 105 inhabitants (33% of increase by year), having been most noticeable in Carlos J. Finlay and Portuondo heath areas (respectively annual average 112.7% y 36.2% increases). Taking into account that the control program was strengthened in 1995, the rates dropped by 47.6% in this municipality during the 1995-2000 period. The Finlay and Portuondo areas respectively lowered their rates by 79.9% y 39.7% while the Gonzalez Coro area showed a 58.3% rise and 27 de Noviembre area had no major change. The age and above 60 group had the higher percentage of cases, recording 49,8% of the total and only one case among children under age 15 for the period. During this same period, only six cases of tuberculosis/human inmunodeficiency virus were diagnosed. The 27 de Noviembre area was the only one found to be at the unsatisfactory level according to the stratification. Conclusions: An initially upward trend, followed by a downward trend in tuberculosis was found to exist in the Marianao Municipality throughout the period studied. This disease was predominant among older adults.