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BACKGROUND: Both chronic obstructive pulmonary disease (COPD) and tuberculosis (TB) primarily affect the lungs and are major causes of morbidity and mortality worldwide. COPD and TB have common risk factors such as smoking, low socioeconomic status and dysregulation of host defence functions. COPD is a prevalent co-morbid condition, especially in elderly with TB but in contrast to other diseases known to increase the risk of TB, relatively little is known about the specific relationship and impact from COPD on TB-incidence and mortality. METHODS AND FINDINGS: All individuals > or = 40 years of age, discharged with a diagnosis of COPD from Swedish hospitals 1987-2003 were identified in the Swedish Inpatient Register (n = 115,867). Records were linked to the Swedish Tuberculosis Register 1989-2007 and the relative risk of active TB in patients with COPD compared to control subjects randomly selected from the general population (matched for sex, year of birth and county of residence) was estimated using Cox regression. The analyses were stratified by year of birth, sex and county of residence and adjusted for immigration status, socioeconomic status (SES) and inpatient co-morbidities previously known to increase the risk of TB. COPD patients had a three-fold increased hazard ratio (HR) of developing active TB (HR 3.0 (95% confidence interval 2.4 to 4.0)) that was mainly dependent on an increased risk of pulmonary TB. In addition, logistic regression estimates showed that COPD patients who developed active TB had a two-fold increased risk of death from all causes within first year after the TB diagnosis compared to the general population control subjects with TB (OR 2.2, 95% confidence interval 1.2 to 4.1). CONCLUSIONS: This population-based study comprised of a large number of COPD patients shows that these patients have an increased risk of developing active TB compared to the general population. The results raise concerns that the increasing global burden of COPD wil

Multiresistent tbc diagnostiserades hos 52 patienter i Sverige 1991–2003. I maj 2007 levde 65 procent av dessa patienter, 19 procent var döda, och för 15 procent var hälsoläget okänt. Inom 24 månader från dia­gnos hade 21 procent fått recidiv och 12 procent dött. Multiresistent tbc var övervägande importerad. Sekundär smittspridning i Sverige konstaterades genom molekylärepidemiologisk typning hos minst ett fall utanför familjen. Trots den allvarliga prognosen överlevde majoriteten av patienterna med hjälp av medicinsk behandling. Siffror från 2007 och 2008 visar en flerfaldig ökning av antalet fall.

Mycobacterium avium is the most common pathogen in children presenting as non-tuberculous mycobacterial lymphadenitis. In Sweden non-tuberculous mycobacterial infection is a notifiable disease. The goal of our study was to determine the annual incidence of M. avium infection in Swedish children, 1998-2003, and describe clinical features related to age and treatment of children with M. avium lymphadenitis. To do this, we retrospectively analysed patient records of 162 children less than 7 y of age from the entire country with culture-verified M. avium disease. The incidence of M. avium infection in Sweden was lower in 2000-2003 than in 1998-1999. Young children (

Tuberkulos är i Sverige numera relativt sällsynt, men sjukdomen har på senare tid fått mycket uppmärksamhet i medierna. En anställd på ett fritidshem fick 1997 diagnos på tuberkulos efter ett års hosta. Av totalt 87 exponerade barn var 14 smittade, varav två med aktiv sjukdom. Ingen bland 25 anställda hade någon säkerställd aktuell smitta. En långtidsuppföljning gjordes sju år senare i Smittskyddsinstitutets centrala tuberkulosregister. Av de exponerade på fritidshemmet fanns inget nytt fall i registret utöver de redan kända. Långvarig och nära kontakt med smittsam tuberkulos medför stor risk att smittas. Övergång i aktiv sjukdom är vanligast under de två första åren efter exponering för tuberkulos.

The number of patients with meningitis and bacteremia due to Haemophilus influenzae was studied in Sweden over the period 1987-1994. Conjugated H. influenzae type b vaccines were introduced in Sweden in 1992, and all children born after December 31, 1992, were offered vaccination free of charge. A rapid decline of H. influenzae meningitis and bacteraemia was observed in the autumn of 1993, when the expected peak incidence failed to appear. In the prevaccination period 1987-1991, the average annual incidence (cases/100,000) was 34.4 in children aged 0-4 years. In 1994, the annual incidence fell to 3.5. No significant decline was observed in older children or adults. There was a 92% reduction in the number of meningitis cases and an 83% reduction in cases of bacteraemia. A similar decline was noted in 2 regions which followed different strategies for the introduction of the vaccination programme.