Two Ways to Tackle Tuberculosis

International screening program and new drug show promise in studies

By Ed Edelson
HealthDay Reporter

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WEDNESDAY, June 3 (HealthDay News) -- In the minds of most Americans, tuberculosis is a disease of the past.

However, statistics show it's still a major global health problem.

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That's why two studies in the June 4 issue of the New England Journal of Medicine are important -- one describes an international effort to detect tuberculosis (TB) among immigrants and refugees coming to the United States, the other reports on highly promising results of a new drug to treat the disease.

According to the World Health Organization, there are nearly 9 million new TB cases and perhaps 1.5 million deaths from the disease annually. Even in the United States, the U.S. Centers for Disease Control and Prevention tallied up 13,293 new cases of TB in 2007.

The research on the new screening program is important because "a substantial portion of newly diagnosed cases in the United States is among foreign-born individuals," explained study author John A. Painter, a team leader for immigrant, refugee and migrant help at the CDC. The TB rate in that group is 9.8 times higher than among U.S.-born individuals -- 20.6 cases per 100,000 people versus 2.1 per 100,000 people for the native-born. Nearly 58 percent of the new TB cases in the United States in 2007 were diagnosed in the foreign-born group.

"The effort to identify persons with tuberculosis in this group is crucial in controlling the disease in the United States," Painter said.

The disease is not always easy to detect in a screening program, he said. "Someone may be infected with TB without having an active disease," Painter said. "One standard technology is a sputum smear. You look under a microscope for the disease. Unfortunately, it is not very sensitive. A new technique is to culture a specimen for six to eight weeks, which allows detection of even a low-level infection. This is more recent and somewhat more involved. It is not universally done. We are focusing on countries where there is a high rate and a large number of cases."

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