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Salud : DATOS EPIDEMIOLÓGICOS DE LA TUBERCULOSIS EN VENEZUELA
on 2012/4/22 21:01:40 (5175 reads)

DATOS EPIDEMIOLÓGICOS DE LA TUBERCULOSIS EN VENEZUELA

Desde 2004, Venezuela está clasificada en el grupo de países de la Región de las Américas con mediana carga de TB. La TB en Venezuela como en otros países es considerada como un problema de salud pública, una enfermedad reemergente. Cuatro factores contribuyen a esta situación de reemergencia de la TB: la epidemia de VIH--SIDA, el incremento de poblaciones marginales, con precarias condiciones sanitarias, desnutrición, hacinamiento y pobreza como la población de personas privadas de libertad y las etnias indígenas; las fallas y descuidos de los programas de salud pública y la resistencia creciente del bacilo tuberculoso a los fármacos. Esta última situación se ha identificado en Venezuela y es de baja intensidad y ocurre principalmente como resistencia secundaria en casos con recaídas.

Hemos recolectado del Reporte Mundial 2011 de Control Global de TB, los datos correspondientes a Venezuela y los hemos contrastado con la limitada y dispersa información oficial disponible en nuestro país sobre los resultados del Programa de Salud Respiratoria del MPPS y del Programa Nacional de Control de Tuberculosis. (PNCTB). Los más recientes datos fueron obtenidos de las Memorias del MPPS de 2010 y 2011, documentos que no han sido publicados en el portal electrónico del MPPS.

Las tasas de  casos nuevos notificados se han mantenido estables, desde 1993. Para entonces era de 23,1 casos nuevos por cada 100.000 habitantes. Ascendieron lentamente hasta 26,6 x 100.000 habitantes en el año 2000. Luego descendieron hasta el valor histórico más bajo en el año 2002, de 20,2 x 100.000 habitantes. Desde entonces, ascendieron lentamente hasta 2005 cuando fue de 25,8 x 100.000 habitantes. En los 6 útimos años ha descendido lentamente hasta 2010, cuando se notificaron 21,9 x 100.000 habitantes. En 2011, nuevamente ascendió a 22,4 x 100.000 habitantes. Estos datos son preliminares y no han sido corregidos.

No obstante, el número absoluto de nuevos casos en 2011 fue de 6.552 el mayor desde 2005.
Los casos registrados de TB en los Boletines Epidemiológicos Semanales del MPPS muestran subregistros cercanos al 100%, situación que pone en evidencia falla en los mecanismos de coordinación y diseminación de información intrainstitucional.

El porcentaje de casos nuevos notificados en 2010 y 2011 en menores de 15 años, se ha mantenido estable entre 7,56% y 7,34% Los casos nuevos notificados en población privada de libertad aumentaron de 47 a 63 (34,04%) en los 2 últimos años. Los casos nuevos en población indígena pasaron de 498 en 2010 a 599 en 2011 (incremento de 20,28%). Los casos nuevos de TB en pacientes con VIH-SIDA pasaron de 398 a 476 en el mismo período, es decir un aumento de 19,59%. Recordemos que en Venezuela, entre enero de 1982 y septiembre de 1997 se reportaron 436 casos de asociación tuberculosis-SIDA.

En los últimos años ha habido un aumento progresivo de los casos de esta asociación. Basta apreciar que en los primeros 15 años de la epidemia el número de casos con esta asociación fue menor que los ocurridos solo en el año 2011. El riesgo de desarrollar TB en pacientes con SIDA es mayor unas 500 veces, especialmente entre los pacientes que muestran una prueba de tuberculina positiva.

La tasa de mortalidad por TB en Venezuela en el quinquenio 1999-2003 fue de 2,8 y en 2005 alcanzó 2,3 por 100.000 habitantes. Datos parciales tenemos desde entonces, por ejemplo, en 2008 ocurrieron 642 muertes por TB (407 en varones y 235 en hembras) la tasa de mortalidad fue de 2,29 x 100.000 habitantes y en 2009 se registraron 551 muertes  por TB (374 en varones y 177 en hembras) Datos recogidos de los Anuarios de Mortalidad del MPPS, 2008 y 2009, con la tasa más baja de mortalidad en el quinquenio en este último año de 1,94 x 100.000 habitantes. Los datos de 1990 y 2000, muestran que la mortalidad en el grupo de 25 a 44 años, la mortalidad en los hombres es el doble de la registrada en las mujeres del mismo grupo de edad. Es posible que esta diferencia sea debida a la coinfección con el VIH, más frecuente en hombres de esas edades.

Si desea leer el documento completo, puede obtenerlo del archivo PDF adjunto: &

Doctores  José Félix Oletta L., Ana C. Carvajal y Saúl O. Peña



Doctores  José Félix Oletta L., Ana C. Carvajal y Saúl O. Peña

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Posted: 2012/12/17 19:09  Updated: 2012/12/17 19:09
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