Sustained Benefit of Community-based Tuberculosis Interventions after 30 Years

Romero, Lelia R.; Sanchez, Ricardo; Accinelli Tanaka, Roberto Alfonso; Garcia, Rosa F.

dc.contributor.author	Accinelli Tanaka, Roberto Alfonso
dc.contributor.author	Romero, Lelia R.
dc.contributor.author	Garcia, Rosa F.
dc.contributor.author	Sanchez, Ricardo
dc.date.accessioned	2019-02-06T14:59:05Z
dc.date.available	2019-02-06T14:59:05Z
dc.date.issued	2015
dc.identifier.uri	https://hdl.handle.net/20.500.12866/5509
dc.description.abstract	In 1985, the overall rate of tuberculosis (TB) in Peru was 145 per 100,000 people, with higher rates seen in isolated regions in the greater Lima area. Between 1985 and 1990, the Peruvian economy shrank 10.1%; the rate of inflation rose, reaching 7,650% in 1990; health care expenditures fell to 0.5% of gross domestic product; and the armed struggle with the Shining Path resulted in more than 70,000 dead and missing. As a result, only 40% of patients with TB in Peru had access to free treatment. Two communities, Leticia Hill and Providence, had some of the highest rates of TB, at 2,570 and 1,950 per 100,000 people, respectively. We undertook a community-based intervention in these areas, which consisted of TB screening with sputum analysis and chest radiography, supervised direct observed treatment for patients with TB, and chemoprophylaxis in patients with latent TB. By combining our physician-directed TB program with community resources, we were able to reduce TB rates by 75% in Leticia Hill and 81.5% in Providence. Here we report sustained benefit of these interventions after 30 years...	en_US
dc.language.iso	eng
dc.publisher	American Thoracic Society
dc.relation.ispartofseries	American Journal of Respiratory and Critical Care Medicine
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject	Humans	en_US
dc.subject	Peru/epidemiology	en_US
dc.subject	Program Evaluation	en_US
dc.subject	Antitubercular Agents/therapeutic use	en_US
dc.subject	Organizational Case Studies	en_US
dc.subject	Mass Screening/methods	en_US
dc.subject	Chemoprevention	en_US
dc.subject	Community Health Services/methods/organization & administration	en_US
dc.subject	Directly Observed Therapy	en_US
dc.subject	Isoniazid/administration & dosage/therapeutic use	en_US
dc.subject	Radiography, Thoracic	en_US
dc.subject	Sputum/cytology	en_US
dc.subject	Time	en_US
dc.subject	Tuberculin Test/methods	en_US
dc.subject	Tuberculosis/diagnosis/drug therapy/epidemiology	en_US
dc.title	Sustained Benefit of Community-based Tuberculosis Interventions after 30 Years	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1164/rccm.201412-2173LE
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.07
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.02.08
dc.relation.issn	1535-4970