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OBJECTIVE To investigate a multi-institutional outbreak of highly resistant tuberculosis and evaluate patient outcome. DESIGN Epidemiologic investigation of every tuberculosis case reported in New York City. SETTING Patients cared for at all public and nonpublic institutions from January 1, 1990, to August 1, 1993 (43 months). PATIENTS We reviewed(More)
SETTING All culture-positive tuberculosis patients without previous treatment for tuberculosis (n = 184), New York City, April 1994. OBJECTIVE To examine factors associated with delays in presenting to a health care provider (patient delay) and in starting antituberculosis treatment (health care system delay). DESIGN Retrospective medical record review(More)
OBJECTIVE To investigate possible cross-contamination of laboratory specimens, as suggested by an increased incidence of newly diagnosed patients with tuberculosis, many of whom had all negative smears for acid-fast bacilli and only one positive Mycobacterium tuberculosis culture referred to as "negative smears, one positive" or NSOP. METHODS(More)
BACKGROUND From 1978 through 1992, the number of patients with tuberculosis in New York City nearly tripled, and the proportion of such patients who had drug-resistant isolates of Mycobacterium tuberculosis more than doubled. METHODS We reviewed, confirmed, and analyzed data obtained during the surveillance of patients with tuberculosis. RESULTS From(More)
BACKGROUND A 1991 survey showed high levels of drug resistance among tuberculosis patients in New York, NY. As a result, the tuberculosis control program was strengthened, including expanded use of directly observed therapy and improved infection control. METHODS We collected isolates from every patient in New York City with a positive culture for(More)
Isoniazid preventive therapy (IPT) is recognised as an important component of collaborative tuberculosis (TB) and human immunodeficiency virus (HIV) activities to reduce the burden of TB in people living with HIV (PLHIV). However, there has been little in the way of IPT implementation at country level. This failure has resulted in a recent call to arms(More)
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(More)