Background: After the resurgence of tuberculosis in the eighties, several institutions pushed to rapidly create tuberculosis programs and to improve the effectiveness of those in existence. The objective of this paper is to evaluate the programs of the Autonomous Communities of Spain.
Material and methods: A questionnaire was sent to 17 Autonomous Communities and two cities Ceuta and Melilla. A table with minimum objectives was made in order to evaluate the impact of each program. The study period was 1996.
Results: The percentage of answers was 100%. Fourteen Autonomous Communities (82%) confirmed they have a tuberculosis program, but with important limitations. There are 3.8 public health workers per 1,000 cases of tuberculosis. Eleven Autonomous Communities had active surveillance, but only 4 know adherence rates to tuberculosis treatments, 3 had supervised treatments, and 3 know diagnostic delays. Ten know results about the percentage of cases with revised contacts. 70% of 19 revised programs did not fulfill the recommended basic objectives.
Conclusions: Tuberculosis control in Spain is not adequate for a developed country. An improvement of the programs in needed, with increase of resources and with reference support centers which would carry out annual evaluations.