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Current approaches to tuberculosis in the United States
1Veterans Affairs Medical Center and George Washington University, Washington, DC, USA.
JAMA
|July 17, 2012
Summary
Tuberculosis control in the US is successful, with low prevalence and few drug-resistant cases. Management strategies must differ from global approaches due to unique US public health resources and demographics.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Tuberculosis (TB) remains a significant global health threat, affecting one-third of the world's population.
- The United States has achieved considerable success in controlling TB, with low prevalence rates.
Observation:
- In the US, only 3.2% have latent TB, and 11,000 active cases occur annually.
- Over half of US TB cases involve individuals born outside the United States.
- Human immunodeficiency virus (HIV) coinfection and drug resistance are uncommon in the US TB cases.
Findings:
- US TB management requires distinct approaches compared to high-prevalence regions due to resource availability and differing case demographics.
- Hospitals in the US often manage more nontuberculous mycobacteria than active TB cases.
Implications:
- Sustained investment in TB diagnostic tools, therapies, and public health infrastructure is crucial for continued progress in the US.
- Adapting successful US strategies to global high and low prevalence settings can help address the worldwide TB challenge.
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