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September 10, 1997, Vol 278, No. 10 >
ARTICLE | September 10, 1997

Defending the Public's Health Against Tuberculosis FREE

Lee B. Reichman, MD, MPH
[+] Author Affiliations

Reprints: Lee B. Reichman, MD, MPH, New Jersey Medical School National Tuberculosis Center, 65 Bergen St, Suite GB1, Newark, NJ 07107-3001.


JAMA. 1997;278(10):865-867. doi:10.1001/jama.1997.03550100091046
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References

Twelve years have passed since the unprecedented resurgence of tuberculosis (TB) in the United States. From 1985 to 1992 TB cases increased almost 20% nationally2 and increased more than 35% in children,3 along with dramatic changes in the nature and magnitude of the disease.4 Despite many contributing factors, including the acquired immunodeficiency syndrome (AIDS) epidemic, increases in substance abuse and homelessness, increased immigration, and lack of patient compliance, concerned observers felt that the TB resurgence was directly due to policymaker neglect of appropriate TB control mandates, which led to the dismantling of programs that had kept TB under control.5,6

See also pp 833, 838, and 843.

The societal response was an unprecedented initiative, a veritable "war" against TB. A multiagency governmental task force was organized to coordinate the effort7; huge increases in congressional appropriations for direct support were obtained6; major research efforts by government

REFERENCES

1 +
 Our motto . Health News . (February) 1914;;30
2 +
Comstock G, Cauthen G.  Epidemiology of tuberculosis . In: Reichman LB, Hershfield E, eds. Tuberculosis: A Comprehensive International Approach . New York, NY: Marcel Dekker; 1993;:23-48.
3 +
Starke JR, Jacobs RF, Jareb T.  Resurgence of tuberculosis in children . J Pediatr . 1992;;120:838-855.
4 +
Snider DE Jr, Roper W.  The new tuberculosis . N Engl J Med . 1992;;328:703-705.
5 +
Reichman LB.  The U shaped curve of concern . Am Rev Respir Dis . 1991;;148:741-742.
6 +
US Congress, Office of Technology Assessment. The Continuing Challenge of Tuberculosis . Washington, DC: US Congress, Office of Technology Assessment; September 1993;. Document OTA-H-574.
7 +
Centers for Disease Control.  National Action Plan to Combat Multidrug Resistant Tuberculosis . MMWR Morb Mortal Wkly Rep . 1992;;41( (RR-11) ):1-48.
8 +
Chaulk CP, Moore-Rice K, Rizzo R, Chaisson RE.  Eleven years of communitybased directly observed therapy for tuberculosis . JAMA . 1995;;274:945-951.
9 +
Moulding J, Dutt AK, Reichman LB.  Fixed dose combination of antituberculous medications to prevent drug resistance . Ann Intern Med . 1995;;122:951-954.
10 +
Galanowsky K, Napolitano E, Wolman M, et al.  Directly observed therapy (DOT) is not the entire answer . Am J Respir Crit Care Med . 1996;;153:A491.
11 +
Reichman LB.  The National Tuberculosis Training Initiative . Ann Intern Med . 1989;;111:197-198.
12 +
Yeager H Jr, Medinger AE.  Tuberculosis long-term beds: have we thrown the baby out with the bath water? Chest . 1986;;90:752-754.
13 +
Etkind SC.  Contact tracing in tuberculosis . In: Reichman LB, Hershfield E, eds. Tuberculosis: A Comprehensive International Approach . New York, NY: Marcel Dekker; 1993;:275-289.
14 +
Waring JJ,  Impact of modern therapy on tuberculosis . JAMA . 1956;;161:1368-1371.
15 +
Moore M, Onorato I, McCray E, Castro KG.  Trends in drug-resistant tuberculosis in the United States, 1993-1996 . JAMA . 1997;;278:833-837.
16 +
Oscherwitz T, Tulsky JP, Roger S, et al.  Detention of persistently nonadherent patients with tuberculosis . JAMA . 1997;;278:843-846.
17 +
Singleton L, Turner M, Haskal R, Etkind S, Tricarico M, Nardell E.  Long-term hospitalization for tuberculosis control: experience with a medical-psychosocial inpatient unit . JAMA . 1997;;278:838-842.
18 +
Centers for Disease Control.  Outbreak of multidrug resistant tuberculosis—Texas, California and Pennsylvania . MMWR Morb Mortal Wkly Rep . 1990;;39:369-372.
19 +
Bloch AB, Cauthen GM, Onorato IM, et al.  Nationwide survey of drug-resistant tuberculosis in the United States . JAMA . 1994;;271:665-671.
20 +
Frieden TR, Fujiwara PI, Washko RM, Hamburg MA.  Tuberculosis in New York City—turning the tide . N Engl J Med . 1995;;333:229-233.
21 +
American Thoracic Society.  Treatment of tuberculosis and tuberculosis infection in adults and children . Am J Respir Crit Care Med . 1994;;149:1359-1374.
22 +
Annas GJ.  Control of tuberculosis—the law and the public's health . N Engl J Med . 1993;;328:585-588.
23 +
American Thoracic Society.  Control of tuberculosis in the United States . Am Rev Respir Dis . 1992;;146:1623-1633.
24 +
Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 1996 . Atlanta, Ga: Centers for Disease Control and Prevention; July 1997;.
25 +
Hearing Before the Subcommittee on Public Health and Government Representatives on HR 14030 April 27, 1972. Washington, DC: US Government Printing Office; 1972:71-75, 89-91.
26 +
Reichman LB.  Tuberculosis elimination—what's to stop us? Int J Tuberc Lung Dis . 1997;;1:3-11.

Figures

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Interactive Graphics

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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

1 +
 Our motto . Health News . (February) 1914;;30
2 +
Comstock G, Cauthen G.  Epidemiology of tuberculosis . In: Reichman LB, Hershfield E, eds. Tuberculosis: A Comprehensive International Approach . New York, NY: Marcel Dekker; 1993;:23-48.
3 +
Starke JR, Jacobs RF, Jareb T.  Resurgence of tuberculosis in children . J Pediatr . 1992;;120:838-855.
4 +
Snider DE Jr, Roper W.  The new tuberculosis . N Engl J Med . 1992;;328:703-705.
5 +
Reichman LB.  The U shaped curve of concern . Am Rev Respir Dis . 1991;;148:741-742.
6 +
US Congress, Office of Technology Assessment. The Continuing Challenge of Tuberculosis . Washington, DC: US Congress, Office of Technology Assessment; September 1993;. Document OTA-H-574.
7 +
Centers for Disease Control.  National Action Plan to Combat Multidrug Resistant Tuberculosis . MMWR Morb Mortal Wkly Rep . 1992;;41( (RR-11) ):1-48.
8 +
Chaulk CP, Moore-Rice K, Rizzo R, Chaisson RE.  Eleven years of communitybased directly observed therapy for tuberculosis . JAMA . 1995;;274:945-951.
9 +
Moulding J, Dutt AK, Reichman LB.  Fixed dose combination of antituberculous medications to prevent drug resistance . Ann Intern Med . 1995;;122:951-954.
10 +
Galanowsky K, Napolitano E, Wolman M, et al.  Directly observed therapy (DOT) is not the entire answer . Am J Respir Crit Care Med . 1996;;153:A491.
11 +
Reichman LB.  The National Tuberculosis Training Initiative . Ann Intern Med . 1989;;111:197-198.
12 +
Yeager H Jr, Medinger AE.  Tuberculosis long-term beds: have we thrown the baby out with the bath water? Chest . 1986;;90:752-754.
13 +
Etkind SC.  Contact tracing in tuberculosis . In: Reichman LB, Hershfield E, eds. Tuberculosis: A Comprehensive International Approach . New York, NY: Marcel Dekker; 1993;:275-289.
14 +
Waring JJ,  Impact of modern therapy on tuberculosis . JAMA . 1956;;161:1368-1371.
15 +
Moore M, Onorato I, McCray E, Castro KG.  Trends in drug-resistant tuberculosis in the United States, 1993-1996 . JAMA . 1997;;278:833-837.
16 +
Oscherwitz T, Tulsky JP, Roger S, et al.  Detention of persistently nonadherent patients with tuberculosis . JAMA . 1997;;278:843-846.
17 +
Singleton L, Turner M, Haskal R, Etkind S, Tricarico M, Nardell E.  Long-term hospitalization for tuberculosis control: experience with a medical-psychosocial inpatient unit . JAMA . 1997;;278:838-842.
18 +
Centers for Disease Control.  Outbreak of multidrug resistant tuberculosis—Texas, California and Pennsylvania . MMWR Morb Mortal Wkly Rep . 1990;;39:369-372.
19 +
Bloch AB, Cauthen GM, Onorato IM, et al.  Nationwide survey of drug-resistant tuberculosis in the United States . JAMA . 1994;;271:665-671.
20 +
Frieden TR, Fujiwara PI, Washko RM, Hamburg MA.  Tuberculosis in New York City—turning the tide . N Engl J Med . 1995;;333:229-233.
21 +
American Thoracic Society.  Treatment of tuberculosis and tuberculosis infection in adults and children . Am J Respir Crit Care Med . 1994;;149:1359-1374.
22 +
Annas GJ.  Control of tuberculosis—the law and the public's health . N Engl J Med . 1993;;328:585-588.
23 +
American Thoracic Society.  Control of tuberculosis in the United States . Am Rev Respir Dis . 1992;;146:1623-1633.
24 +
Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 1996 . Atlanta, Ga: Centers for Disease Control and Prevention; July 1997;.
25 +
Hearing Before the Subcommittee on Public Health and Government Representatives on HR 14030 April 27, 1972. Washington, DC: US Government Printing Office; 1972:71-75, 89-91.
26 +
Reichman LB.  Tuberculosis elimination—what's to stop us? Int J Tuberc Lung Dis . 1997;;1:3-11.

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