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Failure of Tuberculosis Control: Title and subTitle BreakA Prescription for Change FREE

Eran Bellin, MD
[+] Author Affiliations

Reprint requests to Infectious Disease Service, Montefiore—Rikers Island Health Service, 15-15 Hazen St, East Elmhurst, NY 11370 (Dr Bellin).


JAMA. 1994;271(9):708-709. doi:10.1001/jama.1994.03510330086040
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The dramatic increase in tuberculosis (TB) incidence1 is testimony to the failure of the United States to coordinate its medical care provision, disease surveillance, and societal will to consistently provide TB therapy and monitor TB control.2 In this issue of The Journal, Bloch and colleagues3 demonstrate a remarkable shift in the epidemiology of TB in the United States.

In the 1970s, US health officials believed that indigenous TB was coming under control, its ultimate elimination possible with only an occasional case reactivating in the elderly. Transient increases in TB incidence were attributed to immigrants, such as the Indochinese refugees in the mid 1970s4 and Philippine national World War II veterans in Hawaii in the 1990s.5 These foreign cases brought with them the peril of drug resistance as a result of the indiscriminate and inconsistent use of TB medications in the immigrants' countries of origin. Bloch

REFERENCES

Centers for Disease Control and Prevention.  Tuberculosis morbidity—United States, 1992. MMWR Morb Mortal Wkly Rep . 1993;;42:696-704.
Brudney K, Dobkin J.  Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis . 1991;;144:745-749.
Bloch AB, Cauthen GM, Onorato IM, et al.  Nationwide survey of drug-resistant tuberculosis in the United States. JAMA . 1994;;271:665-671.
Powell KE, Brown ED, Farer LS.  Tuberculosis among Indochinese refugees in the United States. JAMA . 1983;;249:1455-1460.
Centers for Disease Control and Prevention.  Tuberculosis in Philippine national World War II veterans immigrating to Hawaii, 1992-1993. MMWR Morb Mortal Wkly Rep . 1993;;42:656-663.
Alcabes P, Vossenas P, Cohen R, Braslow C, Michaels D, Zoloth S.  Compliance with isoniazid prophylaxis in jail. Am Rev Respir Dis . 1989;;140:1194-1197.
Nardell EA.  Tuberculosis in homeless, residential care facilities, prisons, nursing homes, and other close communities. Semin Respir Infect . 1989;;4:206-215.
Stead WW.  Special problems in tuberculosis: tuberculosis in the elderly and in residents of nursing homes, correctional facilities, long-term care hospitals, mental hospitals, shelters for the homeless and jails. Clin Chest Med . 1989;;10:397-406.
Bellin EY, Fletcher DD, Safyer SM.  Association of tuberculosis infection with increased time in or admission to the New York City jail system. JAMA . 1993;;269: 2228-2231.
Selwyn PA, Sckell BM, Alcabes P, Friedland GH, Klein RS, Schoenbaum EE.  High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. JAMA . 1992;;268:504-509.
Centers for Disease Control.  Nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons—Florida and New York, 1988-1991. MMWR Morb Mortal Wkly Rep . 1991;;40:585-591.
Rouillon A, Perdrizet S, Parrot R.  Transmission of tubercle bacilli: the effects of chemotherapy. Tubercle . 1976;;57:275-299.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Centers for Disease Control and Prevention.  Tuberculosis morbidity—United States, 1992. MMWR Morb Mortal Wkly Rep . 1993;;42:696-704.
Brudney K, Dobkin J.  Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis . 1991;;144:745-749.
Bloch AB, Cauthen GM, Onorato IM, et al.  Nationwide survey of drug-resistant tuberculosis in the United States. JAMA . 1994;;271:665-671.
Powell KE, Brown ED, Farer LS.  Tuberculosis among Indochinese refugees in the United States. JAMA . 1983;;249:1455-1460.
Centers for Disease Control and Prevention.  Tuberculosis in Philippine national World War II veterans immigrating to Hawaii, 1992-1993. MMWR Morb Mortal Wkly Rep . 1993;;42:656-663.
Alcabes P, Vossenas P, Cohen R, Braslow C, Michaels D, Zoloth S.  Compliance with isoniazid prophylaxis in jail. Am Rev Respir Dis . 1989;;140:1194-1197.
Nardell EA.  Tuberculosis in homeless, residential care facilities, prisons, nursing homes, and other close communities. Semin Respir Infect . 1989;;4:206-215.
Stead WW.  Special problems in tuberculosis: tuberculosis in the elderly and in residents of nursing homes, correctional facilities, long-term care hospitals, mental hospitals, shelters for the homeless and jails. Clin Chest Med . 1989;;10:397-406.
Bellin EY, Fletcher DD, Safyer SM.  Association of tuberculosis infection with increased time in or admission to the New York City jail system. JAMA . 1993;;269: 2228-2231.
Selwyn PA, Sckell BM, Alcabes P, Friedland GH, Klein RS, Schoenbaum EE.  High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. JAMA . 1992;;268:504-509.
Centers for Disease Control.  Nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons—Florida and New York, 1988-1991. MMWR Morb Mortal Wkly Rep . 1991;;40:585-591.
Rouillon A, Perdrizet S, Parrot R.  Transmission of tubercle bacilli: the effects of chemotherapy. Tubercle . 1976;;57:275-299.
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