Preventing Multidrug-Resistant Tuberculosis FREE

Alan B. Bloch, MD, MPH; Patricia M. Simone, MD; Eugene McCray, MD; Kenneth G. Castro, MD

[+] Author Affiliations

This article is one of a series addressing emerging and reemerging global microbial threats.

Reprint requests to Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-10, Atlanta, GA 30333 (Dr Bloch).

JAMA. 1996;275(6):487-489. doi:10.1001/jama.1996.03530300071045

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References

ABSTRACT

ABSTRACT | REFERENCES

In the 5 years since the first major outbreaks of multidrug-resistant tuberculosis (MDR TB) in the United States were reported, the epidemiology of MDR TB has become clearer.^1,2 Clinically, the course of illness can be devastating for both human immunodeficiency virus (HIV)—infected and noninfected persons, especially when diagnosis and adequate therapy are delayed.^1,3 However, prompt diagnosis and appropriate therapy can improve the likelihood of a successful outcome.^4-6 Directly observed therapy (DOT) has increasingly become the standard of care⁷ and has been accompanied by dramatic reductions in morbidity and drug resistance, including MDR TB.^8,9 Evidence supports DOT as the adherence-promoting strategy of choice par excellence.

Reflecting an improvement in control efforts is the increase in the proportion of patients completing therapy. In 1993,82% of patients in the United States completed therapy within 12 months, compared with 77% in 1992 (Centers for Disease Control and Prevention [CDC],

REFERENCES

ABSTRACT | REFERENCES

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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