DM prevalence among adults with TB in Barcelona is low and remained stable over the 14-year study period. However, TB patients with DM were potentially more infectious and their clinical management was more complicated.

Background The contacts of people with pulmonary tuberculosis (PTB) have a high risk of becoming infected and developing tuberculosis (TB). Our aim was to determine the incidence of TB and its risk factors in a cohort of contacts with latent TB infection (LTBI) detected through contact tracing of smear-positive PTB cases. Methods and findings We performed a population-based retrospective cohort study including contacts that had LTBI, and were contacts of people with PTB who started treatment between 2008 and 2014. We followed up contacts until they developed TB or until the end date for follow-up (31st December 2016). We used Kaplan-Meier curves to compute incidence at 2 and 5 years, and Cox regression to compute hazard ratios (HR) and their 95% confidence intervals (CI). We analyzed 3097 close contacts of 565 PTB cases. After exclusion of 81 co-prevalent TB cases, 953 contacts had LTBI, of which 14 developed TB. Their risk of developing TB after two and five years was 0.7% (CI: 0.3–1.6) and 1.8% (CI: 1.1–3.1) respectively. Contacts who had not been referred for LTBI treatment had a 1.0% (CI: 0.2–4.0) risk at 5 years. Risk of developing TB at 5 years was 1.2% (CI: 0.5–3.0) among people who completed treatment, and 11.1% (CI: 5.1–23.3) for those who did not. Risk factors for TB were not completing LTBI treatment (HR 9.4, CI: 2.9–30.8) and being female (HR 3.5, CI: 1.1-11-3). Conclusions LTBI treatment plays a fundamental role in decreasing the risk of developing TB. It is necessary to achieve a maximum contact tracing coverage and the highest possible compliance with LTBI treatment.

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The aims of this study were to describe the evolution of acute hepatitis C virus (HCV) infections since 2004 and to determine its associated factors. Acute HCV infections diagnosed in Barcelona from 2004 to 2015 were included. Incidence ratios (IR) were then estimated for sex and age groups. Cases were grouped between 2004–2005, 2006–2011 and 2012–2015, and their incidence rate ratios (IRR) were calculated. In addition, risk factors for acute HCV infection were identified using multinomial logistic regression for complete, available and multiple imputed data. 204 new HCV cases were identified. Two peaks of higher IR of acute HCV infection in 2005 and 2013 were observed. Men and those aged 35–54 had higher IR. IRR for men was 2.9 times greater than in women (95% confidence intervals (CI): 1.8 ‒ 4.7). Factors related to the period 2012–2015 (versus 2006–2011) were: a) sexual risk factor for transmission versus nosocomial (relative-risk ratio (RRR): 13.0; 95% CI: 2.3 ‒ 72.1), b) higher educated versus lower (RRR: 5.4; 95% CI: 1.6 ‒ 18.7), and c) HIV co-infected versus not HIV-infected (RRR: 53.1; 95% CI: 5.7 ‒ 492.6). This is one of the few studies showing IR and RRRs of acute HCV infections and the first focused on a large city in Spain. Sexual risk for transmission between men, higher educational level and HIV co-infection are important factors for understanding current HCV epidemic. There has been a partial shift in the pattern of the risk factor for transmission from nosocomial to sexual.

Abstract.A retrospective, space-time study of whooping cough cases reported to the Public Health Agency of Barcelona, Spain between the years 2000 and 2011 is presented. It is based on 633 individual whooping cough cases and the 2006 population census from the Spanish National Statistics Institute, stratified by age and sex at the census tract level. Cluster identification was attempted using space-time scan statistic assuming a Poisson distribution and restricting temporal extent to 7 days and spatial distance to 500 m. Statistical calculations were performed with Stata 11 and SatScan and mapping was performed with ArcGis 10.0. Only clusters showing statistical significance (P <0.05) were mapped. The most likely cluster identified included five census tracts located in three neighbourhoods in central Barcelona during the week from 17 to 23 August 2011. This cluster included five cases compared with the expected level of 0.0021 (relative risk = 2436, P <0.001). In addition, 11 secondary significant space-time clusters were detected with secondary clusters occurring at different times and localizations. Spatial statistics is felt to be useful by complementing epidemiological surveillance systems through visualizing excess in the number of cases in space and time and thus increase the possibility of identifying outbreaks not reported by the surveillance system.