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Tuesday, August 5, 2008

TB or not TB

Here is something to keep in mind if you encounter foreign-born patients from Sub-Saharan Africa and SE Asia in your U.S. practice or hospital.

A new JAMA study found folks from these areas-- and now living in the US-- were the most likely foreign-born patients to have latent TB. Vietnamese and Filipinos had some of the highest rates, as did Peruvians.

Of course, U.S.-born patients can get TB too; in 2006, they accounted for 43% of cases vs. 57% by foreign-borns.

Also, some good news on the TB front, courtesy of NEJM.

It seems that extensively drug-resistant tuberculosis (XDR-TB) can be cured in HIV-negative patients via outpatient treatment, even in countries with limited resources.

More than 60% of Peruvian patients with XDR-TB in the study were cured after getting personalized, daily treatment at home or in community settings. That's a better cure rate than at most US and European hospitals.

The success of the setting is important, as XDR-TB patients are forcibly quarantined in unsavory TB hospitals in some countries, the authors noted. Perhaps the study will help put an end to that practice.

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