Landesman S H
State University of New York Health Science Center, Division of Infectious Diseases, Brooklyn 11203.
Am J Public Health. 1993 May;83(5):766-8. doi: 10.2105/ajph.83.5.766.
The resurgent tuberculosis epidemic represents--especially in New York City--a failure to maintain a public health infrastructure that was focused on preventing active disease in high-risk populations (i.e., individuals with the human immunodeficiency virus [HIV]) and on treating active tuberculosis patients until cured. Although the tuberculosis problem in New York City and other localities is worsened by homelessness, poverty, and substance abuse, it is possible to bring tuberculosis under control by directing public health resources into targeted programs that enhance compliance with tuberculosis treatment regimen and expand chemoprophylaxis efforts among HIV-infected individuals. These two avenues will decrease, respectively, the number of cases of multidrug-resistant tuberculosis and the total number of new cases.
结核病疫情的再度抬头，尤其在纽约市，表明未能维持一个专注于预防高危人群（即感染人类免疫缺陷病毒[HIV]的个体）活动性疾病以及治疗活动性结核病患者直至治愈的公共卫生基础设施。尽管纽约市和其他地区的结核病问题因无家可归、贫困和药物滥用而恶化，但通过将公共卫生资源投入到有针对性的项目中，加强对结核病治疗方案的依从性，并扩大对HIV感染者的化学预防措施，就有可能控制结核病。这两条途径将分别减少耐多药结核病的病例数和新病例总数。
