Prevalence of respiratory symptomatic in health institutions of Bogotá, Colombia

Abstract

Introduction. One of the greatest challenges in tuberculosis control is the early detection of cases. Detection is hindered by low level of active search for respiratory symptoms by health consultants and the small number of tubercular smear tests ordered by health personnel.
Objective. The prevalence of individuals with respiratory symptoms was estimated in Bogotá Health Service Institutions, along with the proportion of those receiving diagnostic baciloscopies (smear or culture tests).
Materials and methods. A cross sectional survey was carried out in 113 health service institutions located in the city of Bogotá, involved 3,170 users and covered a 10-month period between June 2005 and March 2006. Sampling design was based on a probabilistic, stratified, multistage, cluster-without-replacement strategy. A telephone follow-up and review of laboratory registers was done to identify symptomatic individuals for whom baciloscopy was requested.
Results. The prevalence of symptomatic individuals was 7.5% (95%CI 6.4-8.6%). A higher prevalence occurred in public institutions, 9.5% (95%CI 8.0-10.9%), in institutions of first level, 8.6% (95%CI 7.4-9.8), in persons ≥60 years of age 15.8% (95%CI 12.4-19.2%) and in health users with social security, 7.6% (95% CI 6.4-8.7%). In 47% of symptomatic cases, a baciloscopic procedures were not ordered.
Conclusions. The study updated the prevalence of respiratory symptomatic individuals in Colombia and due to the large sample size (and small confidence interval), inferences can be generalized to the entire health service system in Bogotá. The current tuberculosis program goals in Bogotá require adjustment based on the current prevalence of 7.5% compared with a 1977 estimate of 10%.. The study recommends an awareness program for physicians to use TB diagnostic tests in suspect cases.