Background In Italy tuberculosis notification rates constantly decreased between 1955 and 1981; afterwards, increases have been reported. The city of Turin recently experienced a worrying rise of homelessness and drug abuse, and immigration from developing countries occurred increasingly since the late 1980s. An evaluation of tuberculosis rates is necessary to evaluate trends and eventually implement preventive and control strategies. Aim To estimate tuberculosis incidence rates in Turin between 1973 and 1999. Methods Incidence study. An active search of new tuberculosis cases was carried out by examining the clinical records of the three major services for tuberculosis care in the city. Incident cases were defined as patients treated for the first time. General and clinical information was obtained from the clinical records. In order to evaluate the completeness of the series, data were linked with the Tuberculosis Notification Register and the Regional Hospital Discharges Register for the years 1997–99. Results Standardised tuberculosis rates declined from 25.6 in 1973 to 6.4 cases per 100.000 population in 1999; the trend was clearly decreasing for pulmonary tuberculosis, whilst it was slighter for extrapulmonary tuberculosis. Extra-pulmonary localisations were 32.2% of cases. Tuberculosis/HIV co-infection increased after 1985 reaching 16.5% in 1994–96, and showed a big decrease in 1997–99. Foreign-born resident tuberculosis cases reached 25.8% of cases in 1997–99. Tuberculosis rates among Italian non-HIV people increased with the age and mostly interested the elderly, whilst among foreign-born and AIDS people interested mainly the young adults. The study was able to capture 59% of cases diagnosed in the city in 1997–1999: for recent years the probable under-estimation of rates is then about 41%. Conclusions In recent years, new cases of tuberculosis are diagnosed mostly among HIV positive people and immigrants from high prevalence countries. Preventive and control strategies should focus on these population groups, improving quick identification and effective treatment of cases, and implementing accessible services.
Tuberculosis incidence in Turin, Italy: 1973-1999
VERSINO, Elisabetta;VIGNA-TAGLIANTI, Federica;
2003-01-01
Abstract
Background In Italy tuberculosis notification rates constantly decreased between 1955 and 1981; afterwards, increases have been reported. The city of Turin recently experienced a worrying rise of homelessness and drug abuse, and immigration from developing countries occurred increasingly since the late 1980s. An evaluation of tuberculosis rates is necessary to evaluate trends and eventually implement preventive and control strategies. Aim To estimate tuberculosis incidence rates in Turin between 1973 and 1999. Methods Incidence study. An active search of new tuberculosis cases was carried out by examining the clinical records of the three major services for tuberculosis care in the city. Incident cases were defined as patients treated for the first time. General and clinical information was obtained from the clinical records. In order to evaluate the completeness of the series, data were linked with the Tuberculosis Notification Register and the Regional Hospital Discharges Register for the years 1997–99. Results Standardised tuberculosis rates declined from 25.6 in 1973 to 6.4 cases per 100.000 population in 1999; the trend was clearly decreasing for pulmonary tuberculosis, whilst it was slighter for extrapulmonary tuberculosis. Extra-pulmonary localisations were 32.2% of cases. Tuberculosis/HIV co-infection increased after 1985 reaching 16.5% in 1994–96, and showed a big decrease in 1997–99. Foreign-born resident tuberculosis cases reached 25.8% of cases in 1997–99. Tuberculosis rates among Italian non-HIV people increased with the age and mostly interested the elderly, whilst among foreign-born and AIDS people interested mainly the young adults. The study was able to capture 59% of cases diagnosed in the city in 1997–1999: for recent years the probable under-estimation of rates is then about 41%. Conclusions In recent years, new cases of tuberculosis are diagnosed mostly among HIV positive people and immigrants from high prevalence countries. Preventive and control strategies should focus on these population groups, improving quick identification and effective treatment of cases, and implementing accessible services.
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