{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:42:15Z","timestamp":1759538535569,"version":"build-2065373602"},"reference-count":25,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[1999,2]]},"abstract":"<jats:p>BACKGROUND: The HIV\/AIDS epidemic has caused an excess of tuberculosis cases in Spain and in other countries, but its impact on tuberculosis infection is less well understood. This study presents a massive screening undertaken to estimate the prevalence of tuberculous infection in a cohort of primary school entrants. The evolution of the risk of infection is studied by comparison with previous data in the same population. METHODS: Tuberculin skin test screening with 2TU of PPD RT 23 of first grade students in the primary schools of Barcelona, in the 1994-95 school year (cohort born in 1988). Information was also sought from families of unscreened children. Contacts of PPD+ children were traced to locate index cases. The results were also linked to the case registry of the tuberculosis control programme. RESULTS: The prevalence of tuberculin reactors free of BCG vaccination among the 11,080 schoolchildren screened belonging to the 1988 cohort was 0.76%. A 3% annual decline in the annual risk of infection is estimated by comparison with previous data. The identification of 24 cases with a previous history of tuberculosis disease and of 13 cases with active disease diagnosed after the screening was possible by the follow up of these tuberculin positive children and of the information provided by families of unscreened pupils. The screening detected 1.5 new cases of tuberculosis per 1000 tuberculin tests performed. Tuberculosis infection could be traced to HIV infected tuberculosis cases for at least 6% of the positive schoolchildren. CONCLUSIONS: The decline of the annual risk of infection continues in Barcelona, although at a slower pace than before the HIV\/AIDS epidemic, probably attributable to the influence of injecting drug users with smear positive tuberculosis and HIV\/AIDS.<\/jats:p>","DOI":"10.1136\/jech.53.2.112","type":"journal-article","created":{"date-parts":[[2009,1,5]],"date-time":"2009-01-05T14:15:53Z","timestamp":1231164953000},"page":"112-117","source":"Crossref","is-referenced-by-count":8,"title":["Tuberculosis infection and disease among schoolchildren: the influence of the HIV epidemic and of other factors."],"prefix":"10.1136","volume":"53","author":[{"given":"J R","family":"Villalb\u00ed","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Gald\u00f3s-Tang\u00fc\u00eds","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J A","family":"Cayl\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Casa\u00f1as","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Ferrer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Nebot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1999,2,1]]},"reference":[{"key":"ref_1","first-page":"703","article-title":"Situaci\u00f3n actual de la tuberculosis en Espa\u00f1a. Una perspectiva sanitaria en precario respecto a los pa\u00edses desarrollados","volume":"105","author":"Rey, R.; Ausina, V.; Casal, M.; Cayl\u00e0, J.; de March, P.; Moreno, S.","year":"1995","unstructured":"Rey R, Ausina V, Casal M, Cayl\u00e0 J, de March P, Moreno S, et al. Situaci\u00f3n actual de la tuberculosis en Espa\u00f1a. Una perspectiva sanitaria en precario respecto a los pa\u00edses desarrollados. Med Clin (Barc) 1995;105:703\u20137.","journal-title":"Med Clin (Barc)"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1164\/ajrccm\/144.4.745","article-title":"Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs","volume":"144","author":"Brudney, K.; Dobkin, J.","year":"1991","unstructured":"Brudney K, Dobkin J. Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis 1991;144:745\u20139.","journal-title":"Am Rev Respir Dis"},{"key":"ref_3","first-page":"187","article-title":"La evoluci\u00f3n de la infecci\u00f3n VIH\/sida en los pa\u00edses desarrollados. Impacto sobre la tuberculosis","volume":"100","author":"de March P; A, Garc\u00eda","year":"1993","unstructured":"de March P, Garc\u00eda A. La evoluci\u00f3n de la infecci\u00f3n VIH\/sida en los pa\u00edses desarrollados. Impacto sobre la tuberculosis. Med Clin (Barc) 1993;100:187\u201393.","journal-title":"Med Clin (Barc)"},{"issue":"2","key":"ref_4","first-page":"25","article-title":"The potential impact of AIDS on the tuberculosis situation in developed and developing countries","volume":"63","author":"Styblo, K.","year":"1988","unstructured":"Styblo K. The potential impact of AIDS on the tuberculosis situation in developed and developing countries. Bulletin International Union Tuberculosis 1988;63 (suppl 2):25\u20138.","journal-title":"Bulletin International Union Tuberculosis"},{"key":"ref_5","first-page":"286","article-title":"Epidemiolog\u00eda del s\u00edndrome de inmunodeficiencia adquirida en Barcelona","volume":"101","author":"Cayl\u00e0, J.A.; Jans\u00e0, J.M.; Iglesias, B.; Artazcoz, L.; Plas\u00e8ncia, A.","year":"1981","unstructured":"Cayl\u00e0 JA, Jans\u00e0 JM, Iglesias B, Artazcoz L, Plas\u00e8ncia A. Epidemiolog\u00eda del s\u00edndrome de inmunodeficiencia adquirida en Barcelona (1981\u20131991)(I). Estudio descriptivo y de tendencias temporales. Med Clin (Barc) 1993;101:286\u201393.","journal-title":"Med Clin (Barc); Estudio descriptivo y de tendencias temporales"},{"key":"ref_6","first-page":"441","article-title":"Evoluci\u00f3n de la epidemia de sida en Catalu\u00f1a: an\u00e1lisis descriptivo del registro de casos","volume":"92","author":"Casabona, J.; Salas, T.; Segura, A.","year":"1989","unstructured":"Casabona J, Salas T, Segura A. Evoluci\u00f3n de la epidemia de sida en Catalu\u00f1a: an\u00e1lisis descriptivo del registro de casos. Med Clin (Barc) 1989;92:441\u20136.","journal-title":"Med Clin (Barc)"},{"key":"ref_7","first-page":"371","article-title":"El declive de la infecci\u00f3n tuberculosa en escolares de Barcelona","volume":"91","author":"Villalb\u00ed, JR, Cayl\u00e0; JA, Taberner; JL, Serra; T.","year":"1988","unstructured":"Villalb\u00ed JR, Cayl\u00e0 JA, Taberner JL, Serra T. El declive de la infecci\u00f3n tuberculosa en escolares de Barcelona. Med Clin (Barc) 1988;91:371\u20134.","journal-title":"Med Clin (Barc)"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/0962-8479(94)90038-8","article-title":"The evolution of tuberculosis infection among schoolchildren in Barcelona and the HIV epidemic","volume":"75","year":"1994","unstructured":"Villalb\u00ed JR, Cayl\u00e0 JA, Iglesias B, Ferrer A, Casa\u00f1as P. The evolution of tuberculosis infection among schoolchildren in Barcelona and the HIV epidemic. Tuber Lung Dis 1994;75: 105\u20139.","journal-title":"Tuber Lung Dis"},{"article-title":"Comit\u00e9 d\u2019Experts en Tuberculosi. Guia per a la prevenci\u00f3 i control de la tuberculosi","year":"1992","key":"ref_9","unstructured":"Comit\u00e9 d\u2019Experts en Tuberculosi. Guia per a la prevenci\u00f3 i control de la tuberculosi. Barcelona: Publicacions de la Generalitat de Catalunya, 1992."},{"key":"ref_10","first-page":"24","article-title":"Grupo de Trabajo sobre Tuberculosis. Consenso nacional para el control de la tuberculosis en Espa\u00f1a","volume":"98","year":"1992","unstructured":"Grupo de Trabajo sobre Tuberculosis. Consenso nacional para el control de la tuberculosis en Espa\u00f1a. Med Clin (Barc) 1992;98:24\u201331.","journal-title":"Med Clin (Barc)"},{"key":"ref_11","first-page":"5","article-title":"Sensibilidad cruzada entre tuberculina RT23 y sensitinas de micobacterias at\u00edpicas","volume":"4","author":"Taberner, J.L.","year":"1982","unstructured":"Taberner JL. Sensibilidad cruzada entre tuberculina RT23 y sensitinas de micobacterias at\u00edpicas. Gac Sanit 1982;4:5\u20137.","journal-title":"Gac Sanit"},{"key":"ref_12","first-page":"141","article-title":"Micobacterias no tuberculosas en Barcelona (I). Sensibilizaciones comparativas entre tuberculina RT23 con sensitinas del Mycobacterium avium y Scrofulaceum","volume":"175","author":"de March-Ayuela P","year":"1984","unstructured":"de March-Ayuela P. Micobacterias no tuberculosas en Barcelona (I). Sensibilizaciones comparativas entre tuberculina RT23 con sensitinas del Mycobacterium avium y Scrofulaceum. Rev Clin Esp 1984;175:141\u20137.","journal-title":"Rev Clin Esp"},{"issue":"42","key":"ref_13","first-page":"5","article-title":"The transmission of tubercle bacilli. Its trend in a human population","volume":"1969","author":"Styblo, K.; Meijer, J.; Sutherland, I.","unstructured":"Styblo K, Meijer J, Sutherland I. The transmission of tubercle bacilli. Its trend in a human population. Bulletin International Union Tuberculosis 1969;42:5\u2013104.","journal-title":"Bulletin International Union Tuberculosis"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/0962-8479(95)90552-9","article-title":"Methodological issues in the estimation of the tuberculosis problem from tuberculin surveys","volume":"76","author":"Rieder, H.L.","year":"1995","unstructured":"Rieder HL. Methodological issues in the estimation of the tuberculosis problem from tuberculin surveys. Tuber Lung Dis 1995;76:114\u201321.","journal-title":"Tuber Lung Dis"},{"key":"ref_15","first-page":"25","article-title":"Indicadores de salud de la Regi\u00f3n de Murcia: actualizaci\u00f3n 1996","volume":"17","author":"de Epidemiolog\u00eda, Servicio","year":"1996","unstructured":"Servicio de Epidemiolog\u00eda. Indicadores de salud de la Regi\u00f3n de Murcia: actualizaci\u00f3n 1996. Bolet\u00edn Epidemiol\u00f3gico de Murcia 1996;17:25\u201332.","journal-title":"Bolet\u00edn Epidemiol\u00f3gico de Murcia"},{"key":"ref_16","first-page":"573","article-title":"Infecci\u00f3n tuberculosa en escolares de 1o de EGB de la Regi\u00f3n de Murcia","volume":"12","author":"Navarro-Alonso, J.A.; Hernando-Arizaleta, L.; Galva\u00f1-Olivares, F.; Calle-Urra, J.E.","year":"1985","unstructured":"Navarro-Alonso JA, Hernando-Arizaleta L, Galva\u00f1-Olivares F, Calle-Urra JE. Infecci\u00f3n tuberculosa en escolares de 1o de EGB de la Regi\u00f3n de Murcia (1985\u20131992). Aten Primaria 1993;12:573\u20136.","journal-title":"Aten Primaria"},{"key":"ref_17","article-title":"Encuesta de tuberculina en la Comunidad de Madrid","author":"Ordob\u00e1s-Gav\u00edn, M.","year":"1995","unstructured":"Ordob\u00e1s-Gav\u00edn M. Encuesta de tuberculina en la Comunidad de Madrid. Madrid: Consejer\u00eda de Sanidad y Servicios Sociales, 1995."},{"key":"ref_18","first-page":"365","article-title":"Epidemiologia de la tuberculosis en","volume":"104","year":"1995","unstructured":"Garc\u00eda-Rodr\u00edguez JF, De Juan-Prego, Rodr\u00edguez-Mayo M, Sesma-S\u00e1nchez P, Gonz\u00e1lez-Moraleja J. Epidemiologia de la tuberculosis en El Ferrol. Med Clin (Barc) 1995;104: 365\u20138.","journal-title":"El Ferrol. Med Clin (Barc)"},{"key":"ref_19","first-page":"521","article-title":"Evoluci\u00f3n de la incidencia de enfermedad tuberculosa en el \u00e1rea sanitaria de La Coru\u00f1a","volume":"68","author":"Castro, I.; Jim\u00e9nez, F.J.; Rosales, M.; Dom\u00ednguez, V.","year":"1994","unstructured":"Castro I, Jim\u00e9nez FJ, Rosales M, Dom\u00ednguez V. Evoluci\u00f3n de la incidencia de enfermedad tuberculosa en el \u00e1rea sanitaria de La Coru\u00f1a. Rev Sanid Hig Publica 1994;68:521\u2013 30.","journal-title":"Rev Sanid Hig Publica"},{"key":"ref_20","first-page":"320","article-title":"La salud de los inmigrantes y la atenci\u00f3n primaria","volume":"15","year":"1995","unstructured":"Jans\u00e0 JM, Villalb\u00ed JR. La salud de los inmigrantes y la atenci\u00f3n primaria. Aten Primaria 1995;15:320\u20137.","journal-title":"Aten Primaria"},{"key":"ref_21","first-page":"525","article-title":"Tuberculosis en inmigrantes reci\u00e9n llegados a Barcelona","volume":"106","author":"J, Dur\u00e1n E.Cabezos; M, Ros; M, Terre; F, Zarzuela; JL, Bada","year":"1996","unstructured":"Dur\u00e1n E Cabezos J, Ros M, Terre M, Zarzuela F, Bada JL. Tuberculosis en inmigrantes reci\u00e9n llegados a Barcelona. Med Clin (Barc) 1996;106:525\u20138.","journal-title":"Med Clin (Barc)"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1146\/annurev.pu.04.050183.000441","article-title":"Consequences of the experience of migration","volume":"4","author":"Kasl, S.; Berkman, L.","year":"1983","unstructured":"Kasl S, Berkman L. Consequences of the experience of migration. Ann Rev Public Health 1983;4: 69\u201390.","journal-title":"Ann Rev Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1001\/jama.1995.03530080029037","article-title":"School-based screening for tuberculous infection. A cost-benefit analysis","volume":"274","author":"Mohle-Boetani, J.C.; Miller, B.; Halpern, M.; Trivedi, A.; Lessler, J.; Solomon, S.L.","year":"1995","unstructured":"Mohle-Boetani JC, Miller B, Halpern M, Trivedi A, Lessler J, Solomon SL, et al. School-based screening for tuberculous infection. A cost-benefit analysis. JAMA 1995;274: 613\u201319.","journal-title":"JAMA"},{"key":"ref_24","first-page":"116","article-title":"Epidemiology of tuberculosis in HIV prevalent countries. In: Styblo K. Epidemiology of tuberculosis","author":"Styblo, K.; Enarson, D.A.","year":"1991","unstructured":"Styblo K, Enarson DA. Epidemiology of tuberculosis in HIV prevalent countries. In: Styblo K. Epidemiology of tuberculosis. Selected papers. The Hague: Royal Netherlands Tuberculosis Association, 1991:116\u201336.","journal-title":"Selected papers. The Hague: Royal Netherlands Tuberculosis Association"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1001\/jama.1995.03520270054031","article-title":"Global epidemiology of tuberculosis. Morbidity and mortality of a world-wide epidemic","volume":"273","author":"Raviglione, M.C.; Snider, D.E.; Kochi, A.","year":"1995","unstructured":"Raviglione MC, Snider DE, Kochi A. Global epidemiology of tuberculosis. Morbidity and mortality of a world-wide epidemic. JAMA 1995;273:220\u20136.","journal-title":"JAMA"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech.53.2.112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T15:55:58Z","timestamp":1759506958000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech.53.2.112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,2]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1999,2,1]]},"published-print":{"date-parts":[[1999,2]]}},"alternative-id":["10.1136\/jech.53.2.112"],"URL":"https:\/\/doi.org\/10.1136\/jech.53.2.112","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"type":"print","value":"0143-005X"},{"type":"electronic","value":"1470-2738"}],"subject":[],"published":{"date-parts":[[1999,2]]}}}