Abstract

GONZALEZ OCHOA, Edilberto et al. Trends in tuberculosis incidence in Cuba: lessons learned in 1991-1994 and their relevance in 2004-2012. Rev Cubana Med Trop [online]. 2015, vol.67, n.1, pp.122-138. ISSN 0375-0760.

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.

Keywords : Tuberculosis; surveillance; control; evaluation; Cuba.

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