Tuberculosis control policies in major metropolitan health departments in the United States : VI. Standard of practice in 1996.
Since 1980, we have surveyed at 4-yr intervals the metropolitan health departments initially reporting>250 cases of tuberculosis to determine the perceived standard of practice for tuberculosis control and the factors affecting formulation of treatment policies.
Between 1992 and 1996, use of supervised short-course (6 to 9 mo) intermittent therapy with multiple drugs including isoniazid, ethambutol, pyrazinamide, and rifampin increased from 4.3% to 46% of all new patients.
Pyrazinamide use for initial treatment for children has increased substantially and now predominates (74.2% of patients in 1996 versus 48.1% of patients in 1992).
Duration of treatment, which was 20 ± 2.1 mo in 1980, is now 8.00 ± 2.29 mo in 1996.
The incidence of human immunodeficiency virus-associated tuberculosis, which was virtually unrecognized in 1984, has remained the same between 1992 and 1996 (18.0%). As in previous years, there was a wide variance among health departments in the incidence (<5% to>40%) of HIV-associated tuberculosis.
After years of funding decreases, there has been an impressive increase in resources in the past 4 yr.
In 1988, mean budget allocation for health departments decreased by 7.9% versus the prior 4 yr and, in 1992, there was no overall change in budget allocation after inflation versus 1988.
In 1996, however, funds for treatment increased by 84 ± 33%. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Métropole, Santé, Etats Unis, Amérique du Nord, Amérique, Politique sanitaire, Contrôle, Traitement, Prévention, Organisation santé, Homme
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Metropolitan area, Health, United States, North America, America, Health policy, Check, Treatment, Prevention, Public health organization, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0018154
Code Inist : 002B05B02O. Création : 17/04/1998.