RT Journal Article
SR Electronic
T1 What patients account for the post-socialist increase in pulmonary tuberculosis?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2633
VO 38
IS Suppl 55
A1 Alan Altraja
A1 Piret Viiklepp
A1 Kai Kliiman
A1 Heinart Sillastu
A1 Lea Pehme
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2633.abstract
AB Background: After a steady decline in tuberculosis (TB) from 1954 (417/105/yr) to 1992 (21/105/yr), along with the overwhelming societal and health care changes after independence was declared in 1991, Estonia experienced a resurgence of TB incidence since 1993, which peaked at 47.5/105/yr in 1998, without immigration playing a major role.Aims: To reveal whether patients with particular characteristics accounted for the increasing incidence of pulmonary TB (PTB) in the changed societal conditions (1995–2003) compared to the “low incidence period with a decrease” (1985–1991) to determine the populations under significant risk in such circumstances.Methods: TB-related characteristics of all PTB cases diagnosed during 1985–1991 (n=362, median age 43.0 yr) and 1995–2003 (n=668, median age 44 yr) in Tartu city and county in Estonia were subjected to logistic regression analysis to find determinants of PTB characteristic of the independence period.Results: During independence, there were significantly more smear-positive patients (OR 2.39, 95%CI 1.57-3.64), those who sought help because of symptoms (OR 2.40, 95%CI 1.73-3.31), and those who had had TB contact (OR 5.03, 95%CI 3.68-6.88), but significantly less alcohol abusers (OR 0.60, 95%CI 0.42-0.87), smokers (OR 0.57, 95%CI 0.41-0.81), and those with a cavitary (OR 0.66, 95%CI 0.46-0.96) and a limited disease (OR 0.55, 95%CI 0.31-0.95).Conclusions: Despite continuously free access to care for TB, the common social groups like non-alcoholics and non-smokers more often fall ill with culture-confirmed non-limited PTB and account for the increased incidence of TB after the post-socialist changes.Funded by an ESF grant No. 8118.