Background and Methods After an increase in the number of cases of tuberculosis, New York City passed regulations to address the problem of nonadherence to treatment regimens.
The commissioner of health can issue orders compelling a person to be examined for tuberculosis, to complete treatment, to receive treatment under direct observation, or to be detained for treatment.
On the basis of a review of patients'records, we evaluated the use of these legal actions between April 1993 and April 1995.
Results Among more than 8000 patients with tuberculosis, regulatory orders were issued for less than 4 percent.
Among patients with a variety of social problems, only a minority required regulatory intervention : 10 percent of those with injection-drug use, 16 percent of those with alcohol abuse, 17 percent of those who were homeless, 29 percent of those who used « crack » cocaine, and 38 percent of those with a history of incarceration.
A total of 150 patients were ordered to undergo directly observed therapy, 139 patients to be detained during therapy, 12 patients to be examined for tuberculosis, and 3 patients to complete treatment.
These 304 patients had a median of three prior hospitalizations related to tuberculosis and one episode of leaving the hospital against medical advice.
Repeatedly noncompliant patients and those who left the hospital against medical advice were more likely than others to be detained. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, New York, Etats Unis, Amérique du Nord, Amérique, Traitement, Aspect juridique, Intervention, Programme commande, Homme
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, New York, United States, North America, America, Treatment, Legal aspect, Operation, Control program, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0135252
Code Inist : 002B05B02O. Création : 16/11/1999.