Mortality from tuberculosis in Spain, 1971 to 2007: slow decrease in female and in elderly patients.
Mortality by tuberculosis in Spain remains greater than in other highly developed countries. The aim of this study is to identify the temporal trends in tuberculosis mortality in Spain from 1971 to 2007. Data were obtained from the Spanish National Institute for Statistics. Age- and sex-specific mortality rates and age-adjusted mortality rates were estimated (direct method). Joinpoint regression was used to identify the years when there were changes in mortality trend and the annual percentage change in mortality rates. In men, age-adjusted mortality decreased by 10.3% each year until 1984 and by 7.3% from then on; in women, mortality decreased by 10.4% each year until 1987 but only by 5.1% each year from 1987 on. An age-specific analysis revealed that mortality rates decreased by 10% each year in people younger than 65; from 65 years and older, the greater the age, the slower the annual average decrease (approximately, every additional 5 years is associated with a 1% slower annual percentage change). Tuberculosis mortality in Spain decreases faster in men than in women, and in young adults than in the elderly. Greater efforts should be made to identify the causes of these different trends.