Tuberculosis in Spain [TB0116]

·  2021 TB Cases in Spain

• Total reported cases: 3,754 (151 were imported).
• Non-imported cases: 3,603, with a notification rate (NR) of 7.61 per 100,000.
• Decline in cases:
• 2.18% decrease compared to 2020 (3,686 cases, NR = 7.78).
• 28.07% decrease compared to 2015 (4,913 cases, NR = 10.59).
• Spain classified as low-incidence for TB.

·  TB Control and Prevention Goals (Achieved in 2020)

• Goal 1: Reduce overall TB rate by 15%-21% from 2015 levels.
• Achieved reduction: 26.5%.
• Goal 2: Reduce annual pulmonary TB rate by 4% (2015-2020).
• Achieved reduction: 6%.

·  Regions with Highest and Lowest TB Notification Rates (2021)

• Highest NR: Ceuta, Galicia, Catalonia, Rioja, and the Basque Country.
• Lowest NR: Canary Islands, Castilla La Mancha, Extremadura, and Navarre.

·  Demographics and Mortality

• Higher incidence in men than women (rate ratio 1.7).
• TB incidence similar across ages 25-84.
• Nearly half of TB cases were among foreign-born individuals, with a younger mean age than native-born cases.
• Mortality rate 2.6 times higher in males than females.

·  Risk Factors and Origin of Foreign-Born TB Cases

• Primary risk factor: origin from countries with high TB incidence.
• Top countries of origin in registry: Morocco, Romania, Bolivia, Peru, and Pakistan.
• Average age of foreign-born cases: 39 years.
• More than half resided in Spain for over 10 years; only 13% had lived in Spain for less than 2 years.

·  Directly Observed Therapy (DOT) Implementation in Spain

• Slow implementation, typically for patients with higher risk of non-adherence.
• Adaptable guidelines for DOT (e.g., non-daily supervision, allowances for weekends, holidays, short trips).

Source: Guillén, S.M., et al., 2023. Tuberculosis in Spain: An opinion paper. Rev Esp Quimioter, 36(6), pp.562-583.