Am. J. Respir. Crit. Care Med.,
Volume 165, Number 2, January 2002, 305a-305a
ONE SIZE FITS ALL?
To the Editor :
I thoroughly agree with Drs. Taylor and O'Brien when they state "If we are
going to have a major impact on reducing tuberculosis in the foreign-born,
we will need to have better diagnostic tests and improved, shorter treatment
regimens" (1). However, having the proper tools will not be sufficient if the
populations for whose benefit they are intended do not understand the need
for them and if we do not understand how best to convey our message. A recent report by Dr. Fujiwara has shown that knowledge about the nature of
tuberculosis, understanding the role of the health department, and the most
effective sources of information all varied greatly among different ethnic
groups in New York City (2). If we are to make tuberculosis control as effective among the foreign-born as among the native-born, we must learn to tailor our programs to meet each local situation. In tuberculosis control, one
size does not fit all.
George W.
Comstock
The Johns Hopkins University, Baltimore, Maryland
1.
Taylor Z,
O'Brien RJ.
Tuberculosis elimination. Are we willing to pay
the price?
Am J Respir Crit Care Med
2001;
163:
1-2
[Free Full Text].
2.
Fujiwara PI.
Tide pool: what will be left after the tide has turned?
Int J
Tuberc Lung Dis
2000;
4:
S111-S116
[Medline].
From the Authors:
We thank Dr. Comstock for his interest in our editorial (1). In our brief paper we focused on the need for increased resources for both programmatic
activities as well as research on new tools to improve identification and treatment of high-risk persons with latent tuberculosis (TB) infection.
We fully agree with Dr. Comstock's assertion that to be effective, local
control TB programs need to tailor their services to meet the needs of the
various populations they serve. It has never been sufficient to simply diagnose and provide treatment for TB disease or latent TB infection, and this is
especially true now as programs serve increasingly diverse populations. This point was recently emphasized in the Institute of Medicine report (2) and
was previously stressed in the Centers for Disease Control and Prevention
recommendations for the prevention and control of TB in foreign-born populations (3). Indeed, TB control programs will need to tailor their services
for their particular situation and also have the flexibility to change as the
populations they serve change.
Zachary
Taylor,
and
Richard J.
O'Brien
Centers for Disease Control and Prevention, Atlanta, Georgia
1.
Taylor Z,
O'Brien RJ.
Tuberculosis elimination. Are we willing to pay
the price?
Am J Respir Crit Care Med
2001;
163:
1-2
.
2.
Institute of Medicine. Ending neglect: The elimination of tuberculosis in
the United States. Washington, D.C.: National Academy Press; 2000.
3.
Centers for Disease Control and Prevention. Recommendations for prevention and control of tuberculosis among foreign-born persons: Report of the working group on tuberculosis among foreign-born persons.
MMWR. 1998;47(RR-16):1-27.
