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Free Content Decline in tuberculosis with 19 years of universal directly observed therapy in a comprehensive statewide program [Notes from the field]

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The Mississippi State Department of Health tuberculosis program serves a rural southeastern US state of 2.9 million people in an area of 121 489 km2 (46 907 square miles). Statewide, directly observed therapy (DOT) began in 1986. To evaluate the program's effectiveness, trends in Centers for Disease Prevention and Control program indicators for 1981–2005 were compared and found to be significant (P < 0.0001). Inclusion of rifampin and pyrazinamide in the regimens was reviewed. An annual decline in cases and case rates began in 1990, falling by 65% by 2005. Successful DOT is feasible over a large geographic area.
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Keywords: DOT; TB treatment; rural TB program

Document Type: Short Communication

Affiliations: 1: Division of Infectious Disease, University of Mississippi Medical Center, Jackson, Mississippi, USA; Tuberculosis Division, Mississippi State Department of Health, Jackson, Mississippi, USA; and Division of Infectious Disease and Internal Medicine, G V ‘Sonny’ Montgomery Veterans Affairs Medical Center, Jackson, Mississippi, USA 2: Center for Biostatistics, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA 3: Tuberculosis Division, Mississippi State Department of Health, Jackson, Mississippi, USA 4: Division of Infectious Disease, University of Mississippi Medical Center, Jackson, Mississippi, USA; and District VII, Mississippi State Department of Health, Hattiesburg, Mississippi, USA 5: Division of Infectious Disease, University of Mississippi Medical Center, Jackson, Mississippi, USA; and Division of Infectious Disease, University of Connecticut Health Center, Farmington, Connecticut, USA

Publication date: 2011-06-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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