Southern medical journal · 2010
Public health response to a multidrug-resistant tuberculosis outbreak among Guatemalans in Tennessee, 2007.
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Miramontes Roque, Lambert Lauren, Haddad Maryam B, Boaz Valerie, Hawkins Stephen, Zylstra Margaret, Allen Rachel, Rivers Sheliah, Ali Brenda, Chewning Sarah Stuart, Holt Erin, Warkentin Jon
Аннотация
BACKGROUND: In June 2007, the Tennessee Department of Health notified the Centers for Disease Control and Prevention of four multidrug-resistant tuberculosis (MDR TB) cases in individuals of Guatemalan descent, and requested onsite epidemiologic assistance to investigate this outbreak.
METHODS: A case was defined as either culture-confirmed MDR TB with a drug-susceptibility pattern closely resembling that of the index case, or a clinical diagnosis of active TB disease and corroborated contact with a person with culture-confirmed MDR TB. Medical records were reviewed, and patients and their contacts were interviewed.
RESULTS: Five secondary TB cases were associated with the index case. Of 369 contacts of the index case, 189 (51%) were evaluated. Of those, 97 (51%) had positive tuberculin skin test (TST) results, 79 (81%) began therapy for latent TB infection (LTBI), and 38 (48%) completed LTBI therapy.
CONCLUSION: Despite consistent follow up by public health officials, a low proportion of patients diagnosed with LTBI completed therapy. Clinicians and public health practitioners who serve immigrant communities should be vigilant for MDR TB.
METHODS: A case was defined as either culture-confirmed MDR TB with a drug-susceptibility pattern closely resembling that of the index case, or a clinical diagnosis of active TB disease and corroborated contact with a person with culture-confirmed MDR TB. Medical records were reviewed, and patients and their contacts were interviewed.
RESULTS: Five secondary TB cases were associated with the index case. Of 369 contacts of the index case, 189 (51%) were evaluated. Of those, 97 (51%) had positive tuberculin skin test (TST) results, 79 (81%) began therapy for latent TB infection (LTBI), and 38 (48%) completed LTBI therapy.
CONCLUSION: Despite consistent follow up by public health officials, a low proportion of patients diagnosed with LTBI completed therapy. Clinicians and public health practitioners who serve immigrant communities should be vigilant for MDR TB.
Предметные рубрики MeSH
AdolescentAdultAntitubercular AgentsCenters for Disease Control and Prevention, U.S.Delayed DiagnosisDirectly Observed TherapyDisease OutbreaksEmigrants and ImmigrantsFemaleGuatemalaHumansLatent TuberculosisMaleMiddle AgedPublic Health AdministrationTennesseeTuberculin TestTuberculosis, Multidrug-ResistantUnited States