TUBERCULOSIS IN THE REPUBLIC OF CUBA - ITS POSSIBLE ELIMINATION

Setting: Tuberculosis elimination is a priority in most developed countries. although the AIDS epidemic and drug resistance are a handicap in some of them. Tuberculosis is an even greater problem in developing countries. Objective: To evaluate the epidemiological situation in Cuba, the trend of new cases reported for 1979-91 by clinical category and age group is described. Design: A simple regression model was fitted to the time series data on 'new case' rates taken from the national surveillance system. The annual variation percentage was estimated. Results: From 1979-91 tuberculosis decreased by 59.5% (from 11.6- 4.7 per 10(5) persons per year). This decline occurred in all age groups; 60% of new cases in 1991 were aged 45 years and over, of which 30% were aged 65 and over. Drug resistance of Mycobacterium tuberculosis strains (2.49% in 1989) remains uncommon and HIV infection (0.009% in 1991) is rare in the general population. Conclusions: The continuing steady decline of the number of new cases reported, in addition to the favorable trend of drug resistance and the low rate of HIV infection in the general population so far seem to indicate the real possibility of maintaining the effectiveness of the National Programme for Tuberculosis Control in the future, making it reasonable to formulate new strategies for the elimination of the disease.