Tuberculosis in Louisiana: an update.

The incidence of tuberculosis in the United States declined steadily until 1985 when increases were seen, in part due to the AIDS epidemic. Although the decline resumed in 1992, tuberculosis remains a public health problem in Louisiana and nationally. In Louisiana in 1997, HIV infection was present in 14% of persons with tuberculosis whose HIV status was known. In that year there were 16 cases of tuberculosis that were resistant to at least one first-line anti-tuberculous drug. Infection with Mycobacterium tuberculosis is diagnosed with the tuberculin skin test; the size of induration considered positive varies with the risk status of the person tested. TB infection in immunocompetent persons under age 35 is treated with 6 months of isoniazid. TB disease is generally treated with 4 drugs until antimicrobial sensitivities are known. Directly observed therapy is an inexpensive way to ensure compliance and is routinely used for patients in Louisiana.