Directly Observed Treatment of Tuberculosis -- We Can't Afford Not to Try It

Abstract

In many areas of the United States the battle against tuberculosis is being lost. Two major markers of this failure are the increasing incidence of tuberculosis and the rising prevalence of drug-resistant tuberculous infection. The recent epidemics of multidrug-resistant tuberculosis in several East Coast hospitals and an explosive outbreak in the New York state prison system have taken well in excess of 100 lives^1,2. Since 1985, after 35 years of steadily declining incidence (with declines averaging 6 percent per year), tuberculosis case rates have increased each year. Direct and indirect epidemiologic data indicate that the human immunodeficiency virus . . .