NCJ Number
142289
Journal
PAACNOTES Volume: 5 Issue: 3 Dated: (March 1993) Pages: 116-118
Date Published
1993
Length
3 pages
Annotation
A long, annual decline in the number of tuberculosis cases reported in the U.S. led the Public Health Service to aim toward eliminating the disease by the year 2010. However, between 1985 and 1991, there were 39,000 more cases than would have been expected had that decline continued.
Abstract
At least 15 percent of the reported cases were classified as multidrug-resistant (MDR) TB, which is more difficult to treat and more expensive to cure than other strains. Major outbreaks of MDR-TB have affected prisons, homeless shelters, nursing homes, and hospitals. The rise in TB can be traced to two concurrent phenomena: the HIV epidemic and the decay of the American public health infrastructure. A person with AIDS is 500 times more likely to contract TB than the general population and may suffer severely with the disease, possibly leading to rapid morbidity and mortality. Protecting both the TB victim's civil rights and the public will require reliable and prompt identification of TB, infection control, and treatment. However, conflicts between these two goals arise when persons with TB are labeled recalcitrant or noncompliant, or when public health officials are compelled to isolate them involuntarily. In any case, HIV infection should not provide a rationale for compulsory testing, exclusion, or discrimination based on the potential for TB infection. Future HIV and TB control policies should focus on effective compliance enhancement and better interpersonal communications between public health workers and patients.