Immigrants and tuberculosis control

Article Abstract:

A crackdown on illegal immigration and improved tracking of tuberculosis patients by developing countries may help control the spread of the disease in the US. The health status and medical treatment of most immigrants is determined in their country of origin, but many countries can not do an effective job. In addition, the state of California recently passed a proposition that would deny non-emergency health care to illegal immigrants. The law also requires health care professionals to report illegal aliens to the Immigration and Naturalization Service. This would effectively deny tuberculosis treatment to all illegal immigrants in California, which would pose serious consequences for the health of all residents. Because many developing countries can not provide proper treatment, many immigrants have drug-resistant tuberculosis, which is more difficult to cure. More funding for treatment programs in developing countries, better communication between countries and more effective border control may reduce the spread of drug-resistant tuberculosis in the US.

Editorial, Political aspects, Public health, Immigrants

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Directly observed treatment of tuberculosis: we can't afford not to try it

Article Abstract:

A strategy needs to be developed for the treatment of tuberculosis in the US. The incidence of tuberculosis is increasing with more cases of drug-resistant tuberculosis. The HIV epidemic has been partially responsible for the resurgence of tuberculosis in the late 1980s. Other factors associated with this resurgence include homelessness and substance abuse. Directly observed treatment is one treatment strategy that may need to be used more. This strategy involves direct observation of patients taking their medication to ensure patient compliance. Patients are given a daily dose of medication the first two weeks followed by twice-weekly treatment for approximately six months. This program is affordable with a high rate of treatment success. An intermittent regimen involves the administration of drugs three times a week. A direct observation intermittent regime may be an effective treatment strategy especially for patients in large cities.

Management, Column, Drug therapy, Patient compliance, Antitubercular agents

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Global surveillance for antituberculosis-drug resistance, 1994-1997

Article Abstract:

Resistance to drugs used to treat tuberculosis appears to be widespread. Data from 35 countries participating in surveillance sponsored by the World Health Organization reveal that 12.6% of bacterial isolates linked to tuberculosis worldwide were resistant to at least one anti-tuberculosis drug. Two percent were resistant to more than one drug. Among patients treated for tuberculosis, rates were much higher, at 36% resistance to one drug and 13% resistance to more than one drug. Some countries had higher rates of resistance than others.

Drug resistance in microorganisms, Microbial drug resistance, Mycobacterium tuberculosis

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