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              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Quintile distribution of subdistricts of the city of Seville by incidence of tuberculosis in children aged less than 15 years from 2013 to 2015&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We generated this chart using the software application gvSIG&#44; and data on the geographical distribution of the population aged &#60;15 years of year 2013 for calculating the incidence of tuberculosis in this 3-year period&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">La Asamblea Mundial de la Salud aprob&#243; en mayo de 2014 la Estrategia de la Organizaci&#243;n Mundial de la Salud &#40;OMS&#41; <span class="elsevierStyleItalic">Fin a la Tuberculosis</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a>&#44; con el objetivo de acabar con la epidemia mundial de tuberculosis en el a&#241;o 2035&#46; Para ello se necesitar&#237;a disminuir en un 95&#37; su mortalidad&#44; y en un 90&#37; su tasa de incidencia con respecto a la del a&#241;o 2015&#46; Esta estrategia contiene medidas pol&#237;ticas y presupuestarias&#44; nacionales e internacionales&#44; que incluyen desde la garant&#237;a del acceso universal a los servicios de salud&#44; hasta el abordaje de los determinantes sociales y econ&#243;micos que influyen en la enfermedad<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a>&#46; La tuberculosis es una enfermedad ligada a la pobreza&#44; la exclusi&#243;n social y la desigualdad&#44; y factores como el bajo nivel educativo&#44; el desempleo y el bajo nivel socioecon&#243;mico &#40;NSE&#41; han demostrado estar asociados al aumento de su incidencia y prevalencia<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los pa&#237;ses con menos recursos son los que mayores tasas de incidencia y mortalidad por tuberculosis presentan&#46; Sin embargo&#44; la estrategia de la OMS tambi&#233;n incluye medidas de actuaci&#243;n para los pa&#237;ses con baja incidencia de tuberculosis &#40;menos de 10 casos&#47;100&#46;000 habitante&#47;a&#241;o&#41;&#44; como Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a>&#46; Seg&#250;n el &#250;ltimo informe de <span class="elsevierStyleItalic">la Red Nacional de Vigilancia Epidemiol&#243;gica</span><a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a>&#44; la tasa de incidencia total de tuberculosis en Espa&#241;a en 2016 fue de 10&#44;38 casos&#47;100&#46;000 habitantes &#40;4&#44;10 en menores de 15 a&#241;os de edad&#41;&#46; La tasa de incidencia en menores de 15 a&#241;os en Espa&#241;a de los a&#241;os 2013&#44; 2014 y 2015 fue de 5&#44;33&#59; 4&#44;35 y 5&#44;05 casos&#47;100&#46;000 habitantes&#44; respectivamente&#46; A pesar de que la tendencia de la tasa de incidencia total nacional de tuberculosis es descendente en los &#250;ltimos a&#241;os&#44; su ritmo de descenso es inferior al 11&#37; anual &#40;objetivo marcado por la OMS&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Con el objetivo de analizar la distribuci&#243;n de los casos de tuberculosis de la poblaci&#243;n menor de 15 a&#241;os residente en la ciudad de Sevilla en funci&#243;n del NSE de las &#225;reas de residencia&#44; se calcularon las tasas de incidencia anuales de los casos de tuberculosis en ni&#241;as y ni&#241;os declarados al Servicio de Epidemiolog&#237;a del Distrito Sevilla del Servicio Andaluz de Salud durante los a&#241;os 2013&#44; 2014 y 2015&#46; Tanto la distribuci&#243;n geogr&#225;fica por subdistritos de la ciudad de Sevilla&#44; como la poblaci&#243;n menor de 15 a&#241;os residente en cada subdistrito&#44; se obtuvieron del Instituto Nacional de Estad&#237;stica por medio del <span class="elsevierStyleItalic">Proyecto Urban Audit</span><a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a>&#46; Dado que la poblaci&#243;n por subdistritos del a&#241;o 2014 no est&#225; disponible&#44; la tasa de incidencia del 2014 se calcul&#243; con la poblaci&#243;n del a&#241;o anterior&#46; Los subdistritos de menor NSE se definieron por aquellos que conten&#237;an una o m&#225;s de las 11 <span class="elsevierStyleItalic">Zonas de Necesidad de Transformaci&#243;n Social</span> &#40;ZNTS&#41; que existen en la ciudad de Sevilla&#44; de acuerdo con la clasificaci&#243;n de la Junta de Andaluc&#237;a de zonas residenciales con condiciones estructurales de pobreza &#40;basada en datos econ&#243;micos&#44; educaci&#243;n&#44; desempleo&#44; exclusi&#243;n social&#44; etc&#46;&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>&#46; Se calcul&#243; la raz&#243;n de incidencia &#40;RI&#41; entre los subdistritos que conten&#237;an ZNTS y los que no&#44; para cada uno de los tres a&#241;os&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Las tasas de incidencia anuales de tuberculosis de la poblaci&#243;n menor de 15 a&#241;os de la ciudad de Sevilla para los 3 a&#241;os estudiados superan la media nacional para este grupo de edad&#58; 6&#44;61 casos por 100&#46;000 habitantes menores de 15 a&#241;os en el 2013&#44; 14&#44;71 en el 2014 y 8&#44;54 en el 2015 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Las diferencias m&#225;ximas en el c&#225;lculo de tasa de incidencia por subdistritos del a&#241;o 2014 tomando la poblaci&#243;n por subdistritos del a&#241;o 2013 y la del 2015 fueron de<span class="elsevierStyleHsp" style=""></span>&#43;&#47;&#8722; 3 casos por 100&#46;000 habitantes&#44; sin cambios en las tasas de incidencia por subdistritos con y sin ZNTS de ese a&#241;o 2014&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Las RI anuales entre los subdistritos de Sevilla con zonas estructurales de pobreza y los que no las contienen muestra diferencias importantes de hasta casi 9 veces superior en las zonas m&#225;s desfavorecidas &#40;RI-2013<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#44;73&#59; RI-2014<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;13&#59; RI-2015<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;47&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Estos resultados se unen a la amplia evidencia cient&#237;fica que demuestra la asociaci&#243;n entre pobreza y tuberculosis &#40;tambi&#233;n en la poblaci&#243;n infantil&#41;&#44; y ponen de manifiesto las grandes desigualdades en salud en funci&#243;n del NSE del &#225;rea de residencia de Sevilla para esta enfermedad&#46; Para cumplir el objetivo de la OMS <span class="elsevierStyleItalic">Fin a la tuberculosis&#44;</span> es necesario priorizar los esfuerzos sociosanitarios en la b&#250;squeda activa de casos en las &#225;reas m&#225;s desfavorecidas de nuestras ciudades&#44; as&#237; como sensibilizar a la ciudadan&#237;a y autoridades pol&#237;ticas en el abordaje multidisciplinar de los determinantes sociales de la salud y las desigualdades que generan&#46;</p></span>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n por quintiles de los subdistritos de la ciudad de Sevilla seg&#250;n sus tasas de incidencia de tuberculosis en menores de 15 a&#241;os desde el a&#241;o 2013 al 2015&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Elaboraci&#243;n propia mediante el programa gvSIG&#44; con datos de la poblaci&#243;n menor de 15 a&#241;os del a&#241;o 2013 para el c&#225;lculo de la tasa de incidencia de tuberculosis en el periodo de 3 a&#241;os&#46;</p>"
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                  \t\t\t\t" scope="col">Subdistritos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">A&#241;o 2013</th><th class="td" title="\n
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CARTA CIENTÍFICA
Distribución de las tasas de incidencia de tuberculosis en menores de 15 años según zonas de pobreza de la ciudad de Sevilla
Distribution of tuberculosis incidence rates in children under 15 years old according to poverty areas in Seville
Sebastián Tornero Patricioa,
Autor para correspondencia
sebastornero@yahoo.es

Autor para correspondencia.
, Antonio Daponte Codinab, Liliana Charris-Castroc
a Pediatría de Atención Primaria, Distrito Sevilla de Atención Primaria, Servicio Andaluz de Salud, Centro de Salud Polígono Norte, Sevilla, España
b Ciber de Epidemiología y Salud Pública (CIBERESP) y Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN), Escuela Andaluza de Salud Pública, Granada, España
c Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España
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la tasa de incidencia total de tuberculosis en Espa&#241;a en 2016 fue de 10&#44;38 casos&#47;100&#46;000 habitantes &#40;4&#44;10 en menores de 15 a&#241;os de edad&#41;&#46; La tasa de incidencia en menores de 15 a&#241;os en Espa&#241;a de los a&#241;os 2013&#44; 2014 y 2015 fue de 5&#44;33&#59; 4&#44;35 y 5&#44;05 casos&#47;100&#46;000 habitantes&#44; respectivamente&#46; A pesar de que la tendencia de la tasa de incidencia total nacional de tuberculosis es descendente en los &#250;ltimos a&#241;os&#44; su ritmo de descenso es inferior al 11&#37; anual &#40;objetivo marcado por la OMS&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Con el objetivo de analizar la distribuci&#243;n de los casos de tuberculosis de la poblaci&#243;n menor de 15 a&#241;os residente en la ciudad de Sevilla en funci&#243;n del NSE de las &#225;reas de residencia&#44; se calcularon las tasas de incidencia anuales de los casos de tuberculosis en ni&#241;as y ni&#241;os declarados al Servicio de Epidemiolog&#237;a del Distrito Sevilla del Servicio Andaluz de Salud durante los a&#241;os 2013&#44; 2014 y 2015&#46; Tanto la distribuci&#243;n geogr&#225;fica por subdistritos de la ciudad de Sevilla&#44; como la poblaci&#243;n menor de 15 a&#241;os residente en cada subdistrito&#44; se obtuvieron del Instituto Nacional de Estad&#237;stica por medio del <span class="elsevierStyleItalic">Proyecto Urban Audit</span><a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a>&#46; Dado que la poblaci&#243;n por subdistritos del a&#241;o 2014 no est&#225; disponible&#44; la tasa de incidencia del 2014 se calcul&#243; con la poblaci&#243;n del a&#241;o anterior&#46; Los subdistritos de menor NSE se definieron por aquellos que conten&#237;an una o m&#225;s de las 11 <span class="elsevierStyleItalic">Zonas de Necesidad de Transformaci&#243;n Social</span> &#40;ZNTS&#41; que existen en la ciudad de Sevilla&#44; de acuerdo con la clasificaci&#243;n de la Junta de Andaluc&#237;a de zonas residenciales con condiciones estructurales de pobreza &#40;basada en datos econ&#243;micos&#44; educaci&#243;n&#44; desempleo&#44; exclusi&#243;n social&#44; etc&#46;&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>&#46; Se calcul&#243; la raz&#243;n de incidencia &#40;RI&#41; entre los subdistritos que conten&#237;an ZNTS y los que no&#44; para cada uno de los tres a&#241;os&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Las tasas de incidencia anuales de tuberculosis de la poblaci&#243;n menor de 15 a&#241;os de la ciudad de Sevilla para los 3 a&#241;os estudiados superan la media nacional para este grupo de edad&#58; 6&#44;61 casos por 100&#46;000 habitantes menores de 15 a&#241;os en el 2013&#44; 14&#44;71 en el 2014 y 8&#44;54 en el 2015 &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Las diferencias m&#225;ximas en el c&#225;lculo de tasa de incidencia por subdistritos del a&#241;o 2014 tomando la poblaci&#243;n por subdistritos del a&#241;o 2013 y la del 2015 fueron de<span class="elsevierStyleHsp" style=""></span>&#43;&#47;&#8722; 3 casos por 100&#46;000 habitantes&#44; sin cambios en las tasas de incidencia por subdistritos con y sin ZNTS de ese a&#241;o 2014&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Las RI anuales entre los subdistritos de Sevilla con zonas estructurales de pobreza y los que no las contienen muestra diferencias importantes de hasta casi 9 veces superior en las zonas m&#225;s desfavorecidas &#40;RI-2013<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#44;73&#59; RI-2014<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;13&#59; RI-2015<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;47&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Estos resultados se unen a la amplia evidencia cient&#237;fica que demuestra la asociaci&#243;n entre pobreza y tuberculosis &#40;tambi&#233;n en la poblaci&#243;n infantil&#41;&#44; y ponen de manifiesto las grandes desigualdades en salud en funci&#243;n del NSE del &#225;rea de residencia de Sevilla para esta enfermedad&#46; Para cumplir el objetivo de la OMS <span class="elsevierStyleItalic">Fin a la tuberculosis&#44;</span> es necesario priorizar los esfuerzos sociosanitarios en la b&#250;squeda activa de casos en las &#225;reas m&#225;s desfavorecidas de nuestras ciudades&#44; as&#237; como sensibilizar a la ciudadan&#237;a y autoridades pol&#237;ticas en el abordaje multidisciplinar de los determinantes sociales de la salud y las desigualdades que generan&#46;</p></span>"
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n por quintiles de los subdistritos de la ciudad de Sevilla seg&#250;n sus tasas de incidencia de tuberculosis en menores de 15 a&#241;os desde el a&#241;o 2013 al 2015&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Elaboraci&#243;n propia mediante el programa gvSIG&#44; con datos de la poblaci&#243;n menor de 15 a&#241;os del a&#241;o 2013 para el c&#225;lculo de la tasa de incidencia de tuberculosis en el periodo de 3 a&#241;os&#46;</p>"
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                  \t\t\t\t" scope="col">Subdistritos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">A&#241;o 2013</th><th class="td" title="\n
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Información del artículo
ISSN: 16954033
Idioma original: Español
DOI:10.1016/j.anpedi.2019.04.009
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2019 Julio 54 14 68
2019 Junio 80 27 107
2019 Mayo 15 5 20
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Dr Alfredo García-Alix

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