The new case definition criteria, its impact on epidemiological surveillance in Spain.
Int Conf AIDS 1989 Jun 4-9; 5:173 (abstract no. A.575) De Andres R, Tello O, Medrano MJ; Secretaria General del Plan Nacional sobre el SIDA, Madrid, Spain
Cumulative AIDS cases in Spain on date December 21st. 1988 are 2165. Modifications of case definition criteria for reporting AIDS were undertaken in August 1987 by CDC, accepted by WHO in September and applied by the European countries since January 1st 1988. We have studied the impact of these new criteria of case definition among cases diagnosed in Spain since 1981. Since January 1st. 1988 a 72.58% case increase has been detected applying the new criteria of case definition in respect to the old ones. By the new criteria the retrospective revision of cases diagnosed before this last date classified as no AIDS by the old criteria means a 13.15% increase in 1984, 10.76% in 1985, 13.86% in 1986 and 30.13% in 1987. This impact is clearly higher among IVDU (47.34%) and children born from mothers at risk (58.33%) than in the homosexual transmission category (17.27%). The impact is also different by pathological and transmission categories. Kaposi sarcoma is increased 1.25% in the homosexual transmission category and 4.76% among the IVDU. Nevertheless, a 22.56% increase associated to opportunistic infections is detected in the homosexual transmission (800% increase associated to extrapulmonary tuberculosis), 26.93% among IVDU (7, 900% increase associated to extrapulmonary tuberculosis), a 10.00% in the heterosexual transmission category and 47.22% among children born from mothers at risk. Conclusions: 1) Different impact is observed in different country areas in respect to pathological background and epidemiological pattern. 2) The relevance of these results is important for epidemiological analysis, trends and predictions. 3) This different impact should be considered by Public Health strategies and policies on people's perception about the case number increase.
Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Centers for Disease Control and Prevention (U.S.), Sarcoma, Kaposi, Substance Abuse, Intravenous, Homosexuality, Tuberculosis, Spain, Opportunistic Infections, Risk Management, Retrospective Studies, Child, epidemiology, economics, ICA5
