title: Decline in tuberculosis with 19 years of universal directly observed therapy in a comprehensive statewide program.
abstract: The Mississippi State Department of Health tuberculosis program serves a rural southeastern US state of 2.9 million people in an area of 121,489 km(2) (46,907 square miles). Statewide, directly observed therapy (DOT) began in 1986. To evaluate the program's effectiveness, trends in Centers for Disease Prevention and Control program indicators for 1981-2005 were compared and found to be significant (P < 0.0001). Inclusion of rifampin and pyrazinamide in the regimens was reviewed. An annual decline in cases and case rates began in 1990, falling by 65% by 2005. Successful DOT is feasible over a large geographic area.
authors.affiliation: Division of Infectious Disease, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA. rmwebb@umc.edu
authors.forename: R M
authors.initials: RM
authors.lastname: Webb
authors.forename: A
authors.initials: A
authors.lastname: Penman
authors.forename: M
authors.initials: M
authors.lastname: Holcombe
authors.forename: T
authors.initials: T
authors.lastname: Dobbs
authors.forename: T A
authors.initials: TA
authors.lastname: Mathew
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D023801:Directly Observed Therapy / Q000706:statistics & numerical data*; D005260:Female; D006291:Health Policy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D012424:Rural Population; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology*; D014481:United States; D055815:Young Adult
chemical_list: D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D011718:Pyrazinamide; D012293:Rifampin