The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
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Int. J. Tuberc. Lung Dis. · Jan 1998
Preventability of incident cases of tuberculosis in recently exposed contacts.
Contacts of tuberculosis (TB) cases are at risk for TB. If contact screening and intervention are effective, one would expect a reduced incidence of TB in contacts who have been screened. ⋯ Contacts who underwent screening for TB through a state screening programme had a high incidence of TB during the 2 year follow up. Published rates of TB of 425-670/100000 in untreated contacts suggests that the Victorian screening programme had minimal impact on the natural history of disease progression. Intrinsic programme factors such as the appropriateness of the guidelines, adherence to guidelines and rates of preventive therapy need to be evaluated. The devolution of the TB programme in the 1980s also reduced its efficacy. Systematic assessment of screening programmes for efficacy and outcome is part of good public health practice.
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Int. J. Tuberc. Lung Dis. · Jan 1998
Acute respiratory infections: the forgotten pandemic. Communiqué from the International Conference on Acute Respiratory Infections, held in Canberra, Australia, 7-10 July 1997.
Acute respiratory infections kill 4 million children every year in developing countries, and most of these deaths are caused by pneumonia. This huge loss of life goes virtually unnoticed, despite the fact that we have two very effective ways of preventing many of the deaths from pneumonia: Haemophilus influenzae type b vaccine, and standardised antibiotic treatment regimens. Although H. influenzae type b vaccine has virtually eliminated diseases caused by this organism in children in developed countries, failure to appreciate the importance of this organism and the high cost of the vaccine has meant that it has not been used in developing countries; urgent steps need to be taken to ensure that children in developing countries receive H. influenzae vaccine. ⋯ More resources should be allocated to research on acute respiratory infections. Drug therapy has little effect on the course of viral upper respiratory tract infections. Worldwide, US$8 billion is wasted every year on drugs used to treat the symptoms of acute respiratory infections.
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Int. J. Tuberc. Lung Dis. · Oct 1997
Implementation of universal directly observed therapy at a New York City hospital and evaluation of an out-patient directly observed therapy program.
Directly observed therapy (DOT) program for tuberculosis (TB) at a New York City hospital. ⋯ In-patient surveillance is a highly effective DOT recruitment strategy. A DOT model which elicits patient participation in discharge plans and offers incentives can yield a high rate of voluntary acceptance. Outpatient case management is a highly effective means of ensuring treatment completion, especially in those at risk for poor retention.