Social, Clinical and Microbiological Differential Characteristics of Tuberculosis among Immigrants in Spain

BACKGROUND: To identify the differential tuberculosis (TB) characteristics within the immigrant population with respect to natives in Spain. METHODOLOGY/PRINCIPAL FINDINGS: A prospective cohort study design was implemented to examine the TB cases diagnosed and starting standard antituberculous treatment in Spain, between January 1st 2006 and March 31st 2007. A logistic regression analysis was performed to determine differential characteristics. 1,490 patients were included in the study population, 1,048 natives and 442 (29.7%) immigrants. According to the multivariate analysis, the following variables were significantly associated with immigrant TB cases: younger age (OR = 3.79; CI:2.16-6.62), living in group situation (OR = 7.61; CI:3.38-12.12), lower frequency of disabled (OR:0.08; CI:0.02-0.26) and retired (OR:0.21; CI:0.09-0.48) employment status, lower frequency of pulmonary disease presentation (OR = 0.47; CI:0.24-0.92), primary or emergency care admission (OR = 1.80; CI:1.05-3.06 and OR = 2.16; CI:1.36-3.45), drug resistance (OR = 1.86; CI:1.01-3.46), treatment default (OR:2.12; CI:1.18-3.81), lower frequency of alcohol and cigarette consumption (OR = 2.10; CI:1.42-3.11 and OR = 2.85; CI:2.10-3.87 respectively), more directly observed treatment (OR = 1.68; CI:1.04-2.69), and poor understanding of TB disease and its treatment (OR = 3.11; CI:1.86-5.20). The low percentage of primary MDR-TB in the native population (0.1% vs. 2.2% of immigrants) should be noted. CONCLUSIONS/SIGNIFICANCE: The differences show the need to introduce specific strategies in the management of TB within the immigrant population, including the improvement of social and work conditions

Metodología del 2º estudio de seroprevalencia en España

Seroprevalence studies are designed in popu- lation samples to assess the level and distribu- tion of immunity induced by natural infection of certain infectious agents or by immunization against them. The purpose of the 2nd Seropre- valence Study in Spain is to assess the preva- lence and distribution of immune status against vaccine-preventable diseases and generated by natural infection by other microorganisms. Pathologies specifically included in the study are: poliomyelitis, diphtheria, tetanus, pertus- sis, measles, rubella, mumps, varicella, inva- sive meningococcal disease by serogroup C, hepatitis A, hepatitis B, hepatitis E, hepatitis C and HIV. The study has a similar design of that conducted in 1996, as it is a descriptive cross- sectional study in resident population of 2 to 80 years of age in Spain. Two-stage conglomera- te sampling was carried out on the population aged 2 to 80 years living in Spain, with an initial sample size of 10,000 people. The methodolo- gy of the study is described in this article.Los estudios de seroprevalencia se realizan sobre una muestra de problación con el fin de investigar el nivel y distribución de la inmu- nidad inducida por infección natural de deter- minados agentes infecciosos o por vacunación frente a los mismos. El 2º Estudio de Seropre- valencia en España tiene el objetivo de estimar la prevalencia y distribución del estado inmune frente a las enfermedades inmunoprevenibles y de la generada por infección natural por otros microrganismos. En concreto, las patologías in- cluidas en el estudio son: poliomielitis, difteria, tétanos, tosferina, sarampión, rubéola, parotidi- tis, varicela, enfermedad meningocócica inva- sora por serogrupo C, hepatitis A, hepatitis B, hepatitis C, hepatitis E e infección por virus de la inmunodeficiencia humana (VIH). Para ello, se ha diseñado un estudio similar al realizado en 1996, observacional de tipo transversal en la población residente en España de 2 a 80 años de edad. Se ha realizado un muestreo por con- glomerados bietápico de la población de 2 a 80 años residente en España, con un tamaño mues- tral inicial de 10.000 personas. En este artículo se describe la metodología utilizada en la reali- zación del estudio

Community-wide measles outbreak in the Region of Madrid, Spain, 10 years after the implementation of the Elimination Plan, 2011–2012

We describe a community-wide outbreak of measles due to a D4 genotype virus that took place in the Region of Madrid, Spain, between February 2011 and August 2012, along with the control measures adopted. The following variables were collected: date of birth, sex, symptoms, complications, hospital admission, laboratory test results, link with another cases, home address, places of work or study, travel during the incubation period, ethnic group, and Mumps-Measles-Rubella (MMR) vaccination status. Incidences were calculated by 100,000 inhabitants. A total of 789 cases were identified. Of all cases, 36.0% belonged to Roma community, among which 68.7% were 16 months to 19 y old. Non-Roma cases were predominantly patients from 6 to 15 months (28.1%) and 20 to 39 y (52.3%). Most cases were unvaccinated. We found out that 3.0% of cases were healthcare workers. The first vaccination dose was brought forward to 12 months, active recruitment of unvaccinated children from 12 months to 4 y of age was performed and the vaccination of healthcare workers and of members of the Roma community was reinforced. High vaccination coverage must be reached with 2 doses of MMR vaccine, aimed at specific groups, such as young adults, Roma population and healthcare workers

Challenges and opportunities for the regeneration of multinational worker cooperatives: Lessons from the Mondragon Corporation—a case study of the Fagor Ederlan Group

Organisations with alternative structures have been forced to grow internationally in order to remain competitive in the current global context. Some of the industrial cooperatives that belong to the Mondragon Corporation have since the 1990s followed internationalisation strategies that have increased their competitiveness, the number of their employees and their ability to create wealth. However, these moves have also called into question the founding nature of these enterprises. Recently, the Corporation itself has adopted a discourse based on strengthening workers’ participation in capitalist subsidiaries, but to date, the initiatives taken by its multinational cooperatives have been few and the results not particularly impressive. This article investigates this disconnect, delving into the problems of replicating the cooperative model in these subsidiaries and seeking solutions. It focuses on the case of Fagor Ederlan (Mondragon Corporation), examining the efforts to transform capitalist subsidiaries, especially the ‘cooperativisation’ of the Fagor subsidiary in Tafalla (Spain), which is the biggest regeneration project in Mondragon’s Industrial Division. This work also contributes to the broader field of organisational theory by analysing the tensions and opportunities for regeneration in worker-owned organisations under the current globalised context