Revista Cubana de Medicina Tropical

Diagnosis delays of smear- negative pulmonary tuberculosis patients in a municipality and some hospitals of Havana

Evaluation of Latent Tuberculosis Infection risk in Primary Health Care workers

Usefulness of the nitrate reductase method to detect resistance to second-line anti-tuberculosis drugs

Validity and reliability of synthetics indicators for tuberculosis surveillance and control

New tools for tuberculosis diagnosis

Commission for the diagnosis of bacteriologically negative suspected tuberculosis cases: acceptability of the service by presenting physicians

Tuberculosis risk in the staff of three clinical surgical hospitals at Havana city

Synthetic indicator steadily evaluates the detection of TB cases

Spacer oligonucleotide typing of Mycobacterium tuberculosis in Cuba

**Evidence and pathogenicity mechanisms of Blastocystis sp.**

Elimination of tuberculosis as a public health problem: consensus for its definition

Trends in tuberculosis incidence in Cuba: lessons learned in 1991-1994 and their relevance in 2004-2012

Valoramos algunos indicadores de la tuberculosis en Cuba desde 1972 a 2012 y particularmente en 1991-97 y 2004-2012. La incidencia total descendió desde 1272 casos de tuberculosis (14,4/100000 habitantes) en 1972 hasta 492 (4,7/100000) en 1991 y después ascendió hasta 1617 (14,7/100000) en 1994. Mientras el Producto Interno Bruto disminuía desde 20960 millones de pesos en 1989 hasta 14332 millones en 1993, en ese periodo la mortalidad infantil bajaba sostenidamente desde 10,7/1000 nacidos vivos en 1990 hasta 9,9 en 1994, pese a la reducción del Producto Interno Bruto lo que denota la prioridad brindada al programa materno-infantil a expensa del deslizamiento de la prioridad de la tuberculosis. A partir de 1995, con una intervención renovada, la incidencia cayó nuevamente hasta 7,2 en 2003, pero fluctuó entre 6 y 7/100000 entre 2004 y 2012 pese al aumento de la pesquisa de los sintomáticos respiratorios. En este último periodo, en los <15 años de edad, la incidencia se alzó, aunque con cifras pequeñas desde 0,3 hasta 0,9/100000. La coinfección tuberculosis /VIH/sida aumentó desde 4,5 % (33/736) en 2004 hasta 8 % (56/688) en 2012 dentro del total de casos de tuberculosis. Podríamos pensar acorde con estos datos, en un posible cambio de la tendencia, y según las lecciones aprendidas en 1991-94, acerca de la prioridad para la asignación de recursos necesarios, que sería importante un replanteo fortalecedor del control para reducir la incidencia sostenidamente hacia la meta de eliminación.

An assessment was conducted of some tuberculosis indicators in Cuba from 1972 to 2012, particularly in 1991-1997 and 2004-2012. Total incidence decreased from 1 272 tuberculosis cases (14.4/100 000 inhabitants) in 1972 to 492 (4.7/100 000) in 1991, and then rose to 1 617 (14.7/100 000) in 1994. While the Gross National Product decreased from 20 960 million pesos in 1989 to 14 332 million in 1993, infant mortality decreased in that same period from 10.7/1 000 live births in 1990 to 9.9 in 1994, despite the reduction in the Gross National Product, a reflection of the priority awarded to the maternal and child health program at the expense of priority to tuberculosis. A renewed intervention was implemented in 1995 as a result of which incidence came down to 7.2 in the year 2003, but ranged between 6 and 7/100 000 between 2004 and 2012, despite the broadening of screening for respiratory symptoms. In the latter period incidence rose in children aged <15 with low values of 0.3 to 0.9/100 000. Tuberculosis / HIV coinfection rose from 4.5% (33/736) in 2004 to 8% (56/688) in 2012 within the total number of tuberculosis cases. These data seem to point to a possible change of trend. The lessons learned in 1991-1994 about priority in the allocation of resources show that a new approach is required to strengthen control and sustainably reduce incidence with a view to achieving the elimination goal.

Genitourinary tuberculosis in an AIDS patient