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2013 ; 103
(7
): 1292-300
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Eliminating tuberculosis one neighborhood at a time
#MMPMID23078465
Cegielski JP
; Griffith DE
; McGaha PK
; Wolfgang M
; Robinson CB
; Clark PA
; Hassell WL
; Robison VA
; Walker KP Jr
; Wallace C
Am J Public Health
2013[Jul]; 103
(7
): 1292-300
PMID23078465
show ga
OBJECTIVES: We evaluated a strategy for preventing tuberculosis (TB) in
communities most affected by it. METHODS: In 1996, we mapped reported TB cases
(1985-1995) and positive tuberculin skin test (TST) reactors (1993-1995) in Smith
County, Texas. We delineated the 2 largest, densest clusters, identifying 2
highest-incidence neighborhoods (180 square blocks, 3153 residents). After
extensive community preparation, trained health care workers went door-to-door
offering TST to all residents unless contraindicated. TST-positive individuals
were escorted to a mobile clinic for radiography, clinical evaluation, and
isoniazid preventive treatment (IPT) as indicated. To assess long-term impact, we
mapped all TB cases in Smith County during the equivalent time period after the
project. RESULTS: Of 2258 eligible individuals, 1291 (57.1%) were tested, 229
(17.7%) were TST positive, and 147 were treated. From 1996 to 2006, there were no
TB cases in either project neighborhood, in contrast with the preintervention
decade and the continued occurrence of TB in the rest of Smith County.
CONCLUSIONS: Targeting high-incidence neighborhoods for active, community-based
screening and IPT may hasten TB elimination in the United States.
|Adolescent
[MESH]
|Adult
[MESH]
|Antitubercular Agents/therapeutic use
[MESH]
|Black or African American
[MESH]
|Child
[MESH]
|Disease Eradication/*methods
[MESH]
|Female
[MESH]
|Geographic Mapping
[MESH]
|Hispanic or Latino
[MESH]
|Humans
[MESH]
|Incidence
[MESH]
|Isoniazid/therapeutic use
[MESH]
|Male
[MESH]
|Mass Screening
[MESH]
|Middle Aged
[MESH]
|Radiography, Thoracic/statistics & numerical data
[MESH]
|Residence Characteristics/statistics & numerical data
[MESH]
|Risk Factors
[MESH]
|Texas/epidemiology
[MESH]
|Tuberculin Test/statistics & numerical data
[MESH]
|Tuberculosis, Pulmonary/diagnosis/drug therapy/*epidemiology/*prevention &
control
[MESH]
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