La tuberculosis en los países desarrollados

Abstract

At the present time, the United States of America enjoys a relatively low incidence of new cases of tuberculosis. However, there are areas of significant weakness in tuberculosis control, most obvious in the large urban centers. Failure to adopt an aggressive attitude towards lowering the incidence in these high incidence areas could very well lead to a general resurgence in case rates and make the eradication of tuberculosis a much more difficult problem than it poses at the present time. The principal defects in our control program lie in the following areas: 1) Lack of a national case register. 2) Shortage of trained medical personnel in the field of tuberculosis. 3) Weaknesses in tuberculosis teaching in medical schools. 4) Confusion created by atypical acid-fast infection. 5) Socioeconomic and educational barriers that stand between the susceptible population and the modern tools of diagnosis and chemotherapy. 6) Failure to use BCG vaccine in selected high-risk groups. There are seven steps I consider essential to the development of a strong program geared to the eradication of tuberculosis.: 1) Define the tuberculosis problem in the country, in terms of the size of the problem and the social groups it attacks. In other words, establish the epidemiology of the disease for each area. 2) Launch a major effort in those areas with the greatest amount of disease. This may involve planned neg