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The following journal articles, listed in reverse chronological order, discuss TB prevention worldwide as a means of eliminating TB in the United States, the interaction of HIV/AIDS and TB, and the rise of drug-resistant TB.

You may call the National Library of Medicine (NLM) toll-free at 888-346-3656 for additional information. You may also access NLM online at http://www.igm.nlm.nih.gov and view journal citations through the MEDLINE database and monographs, meeting abstracts, and government report citations through the AIDSLINE database.

NPIN Resource and Training Center librarians are available at 800-458-5231 to help you search NLM and other Internet sites and to answer other research-related questions.

Disclaimer: This information is made available as a public service. Neither the CDC nor the NPIN endorse the organizations and materials represented. It is the responsibility of the user to evaluate this information prior to use based on individual needs and community standards.

Binkin et al. Tuberculosis prevention control activities in the United States: an overview of the organization of tuberculosis services. The International Journal of Tuberculosis and Lung Disease. 3(8):663-674, 1999.
The authors review trends and the current epidemiology of TB in the United States, present a brief history of TB control efforts in the country, and present the key strategies for TB control in the United States.

Progress toward the elimination of tuberculosis-United States, 1998. Morbidity and Mortality Weekly Report. 48(13):732-736, August 27, 1999.
This CDC report summarizes national TB surveillance data for 1998 and compares them with similar data from previous years. The findings indicate that the overall number of TB cases continued to decrease, and that trends in the number of reported cases and TB incidence varied by geographic area and population characteristics.

Dye et al. Global burden of tuberculosis. The Journal of the American Medical Association. 282:677-686, August 18, 1999.
The authors estimate risk and prevalence of Mycobacterium tuberculosis infection and TB incidence, prevalence, and mortality for 1997.

Sandiford, P. and M. H. Proctor. WHO's DOTS strategy. Lancet. 353(9154):755, February 29, 1999.
The authors state that TB control programs in the United Kingdom that focus on the public health sector should also try to improve treatment provided by private healthcare workers. The authors propose that this strategy would enable programs to reach and cure more patients.

Behr et al. Transmission of Mycobacterium Tuberculosis from patients smear-negative for acid-fast bacilli. Lancet. 353(9151):444, February 6, 1999.
This journal article discusses data from an ongoing study of the molecular epidemiology of TB in San Francisco. The data indicate that TB transmission there is due about 17 percent of the time to patients with smear-negative, culture-positive TB. The authors note that patients with negative smears should not be considered noninfectious.

Tuberculosis outbreaks in prison housing units for HIV-infected inmates-California, 1995-1996. Morbidity and Mortality Weekly Report. 48(4), February 5, 1999.
This CDC report discusses the results of an investigation by the departments of corrections and health services in California into two TB outbreaks that occurred in the HIV units of state prisons and spread to the community. It focuses on the new procedures developed to prevent similar future outbreaks.

Havlir, D. V. and P. F. Barnes. Current Concepts: Tuberculosis in patients with human immunodeficiency virus infection. New England Journal of Medicine. 340(5):367, February 4, 1999.
This research indicates that, when exposed to Mycobacterium tuberculosis, patients living with HIV/AIDS produce less interferon-gamma than do HIV-negative patients with TB, suggesting that reduced T1 lymphocyte response, which produces the interferon, contributes to susceptibility to TB.

Gasner et al. The use of legal action in New York City to ensure treatment of tuberculosis. New England Journal of Medicine. 340(5):359, February 4, 1999.
The authors evaluate the 1993 regulations passed by New York City under which the health commissioner can compel a person to be examined for TB and to receive direct observation treatment (DOT). Of 8,000 cases of TB treated between April 1993 and April 1995, only 150 patients were required to undergo DOT. The authors conclude that most patients, even those with severe social problems, can complete treatment without regulatory intervention.

Mangura, B. T. and L. B. Reichman. Periodic chest radiography: unnecessary, expensive, but still pervasive. Lancet. 353(9149):319, January 23, 1999.
This article asserts that periodic chest radiography is neither cost-effective nor necessary for TB control.

Villarino et al. Comparable specificity of two commercial tuberculin reagents in persons at low risk for tuberculosis infection. Journal of the American Medical Association. 281(2):169, January 13, 1999.
CDC and other researchers compared reaction size and specificity of skin testing using the commercial tuberculin skin test reagents Aplisol and Tubersol with the standard purified protein derivative (PPD-S1) in 1,555 patients at low risk for latent TB infection. They found that all the tests produced similar results. The authors conclude that Aplisol and Tubersol will correctly classify comparable numbers of persons not infected with
M. tuberculosis
and that the product choice used for skin testing has little effect on test performance.

Uplekar et al. Directly observed treatment for tuberculosis. Lancet. 353(9147):145, January 9, 1999.
The authors assert that a recent study from the Center for Epidemiological Research in Southern Africa shows that in the promotion of DOT other methods of TB control should not be overlooked. The study found that, in field conditions, DOT did not offer any improvement over self-supervision.

Weis et al. Universal HIV screening at a major metropolitan TB clinic: HIV prevalence and high-risk behaviors among TB patients. American Journal of Public Health. 89(1):73, January 1999.
This journal article discusses the outcome of universal HIV screening at a public TB clinic in Fort Worth, Texas. The authors conclude that the metropolitan TB clinic is useful for HIV screening and that all TB patients should have access to HIV-antibody testing and counseling.

Lobato, M. N. and P. C. Hopewell. Mycobacterium tuberculosis infection after travel to or contact with visitors from countries with a high prevalence of tuberculosis. American Journal of Respiratory and Critical Care Medicine. 158(6):1871, December 1998.
This journal article discusses the findings that children who have traveled to countries with high TB rates or who have received visitors from those countries are at increased risk for positive skin tests. The authors suggest that TB control programs should investigate travel and household visitors in their analysis of children with positive skin tests for TB, and that children who have traveled to or had visitors from high-prevalence areas should be considered for testing.

Moss, W. Tuberculosis in the home: contact history and childhood tuberculosis in Central Harlem. Clinical Pediatrics. 37(12):753, December 1998.
This article discusses the contact history of childhood cases of TB in Central Harlem, New York City. The author concludes that contact tracing and instituting preventive therapy were inadequate in preventing childhood TB in this group and suggests identifying and treating adult source cases would help prevent the spread of the disease in children.

Hennessey et al. Tuberculin skin test screening practices among U. S. colleges and universities. Journal of the American Medical Association Online. 280(23):2008, December 16, 1998.
This journal article discusses a study of 624 U.S. colleges and universities, which found that 378 schools required tuberculin screening. The authors suggest that public health resources could be optimized through the selective screening of high-risk students.

Dye et al. Prospects for worldwide tuberculosis control under the WHO DOTS strategy. Lancet. 352(9144):1886, December 12, 1998.
This journal article discusses the results of an age-structured mathematical model to determine the effects of directly observed treatment, short-course (DOTS) on worldwide TB rates. The authors estimate that, if action isn't taken to curb the disease, the annual incidence of TB will increase by 41 percent by the year 2020. They recommend improved diagnostic techniques, drugs, and therapy, coupled with targeted preventive therapy.

New TB guidelines. Journal of the American Medical Association Online. 280(20):1735, November 25, 1998.
This article presents new TB guidelines released by the American College of Occupational and Environmental Medicine.

Stephenson, M. Appropriate antibiotic use key to preventing spread of pertussis and TB. Infectious Diseases in Children. 11(10):30, October 1998.
This article indicates that children under two and adolescents are at greatest risk for progression from TB infection to TB disease, although progression is rare in the majority of cases. A minimum of six months therapy is recommended for all children exposed to or infected with TB.

Zwarenstein et al. Randomised controlled trial of self-supervised and directly observed treatment of tuberculosis. Lancet. 52(9137):1340, October 24, 1998.
This journal article discusses the results of a South African study of 216 adults starting pulmonary TB treatment for the first time or being retreated to determine whether directly observed treatment improves completion and outcome of therapy.

Berthet et al. Attenuation of virulence by disruption of the Mycobacterium tuberculosis erp gene. Science. 282(5389):759-62, October 23, 1998.
The virulence of TB-causing mycobacteria depends on their ability to multiply in mammalian hosts. Disruption of the bacterial erp gene, which encodes the exported repetitive protein, impaired multiplication of
M. tuberculosis
and M. bovis Bacille Calmette-Guerin in cultured macrophages and mice. Reintroduction of erp into the mutants restored their ability to multiply, indicating that erp contributes to the virulence of
M. tuberculosis

New drug proves potent against infections. AIDS Alert-International. 13(10):2, October 1998.
This article discusses the results of a study by CDC and Ivory Coast researchers about cotrimoxazole's role as a safe and relatively inexpensive treatment against opportunistic infections, cutting illness and death by half among patients coinfected with AIDS and TB. The drug is already used in the U.S. and other industrialized countries to treat Pneumocystis carinii pneumonia. The study found that the medication cut deaths by 48 percent and reduced hospitalizations by 44 percent.

Griffith, D. E. Tuberculosis control is a team sport. Chest Online. 114(3), September 1998.
This journal article discusses TB control, asserting that TB specialists are the key to effective control of the disease. The author states that although new CDC guidelines have helped reduce the risk of TB among healthcare workers, the decrease is also the result of extensive TB education for healthcare workers.

Acquired multi-drug resistant tuberculosis-Buenaventura, Columbia, 1998. Morbidity and Mortality Weekly Report. 47(36), September 18, 1998.
This article presents the findings of the first investigation of multi-drug resistant TB in Columbia, which found high rates of drug resistance among TB patients who had a history of treatment for an average of 3.5 years.

Castro, K. G. Global tuberculosis challenges. Emerging Infectious Diseases Online. 4(3), July-September 1998.
This article discusses the epidemiology of global TB using information from 212 countries and data derived from a survey of anti-TB drug resistance in 32 nations.

McKenna et al. The fall after the rise: tuberculosis in the United States, 1991 through 1994. American Journal of Public Health. 88(7):1059, July 1998.
CDC researchers report that recent TB epidemiology patterns in the United States indicate improvement in TB treatment and control, based on a decrease between the number of TB cases reported in 1991 and 1992 and the number of cases reported in 1993 and 1994. The decrease was limited to U.S.-born patients and associated with completion of therapy, conversion of sputum, increases in contacts identified per case, and AIDS incidence.

Bayer et al. Directly observed therapy and treatment completion for tuberculosis in the United States: is universal supervised therapy necessary? American Journal of Public Health. 88(7):1052, July 1998.
This article discusses a study of Directly Observed Therapy (DOT) programs in the U.S. between 1990 and 1994. The researchers found that the therapy had a significant effect on improving treatment programs with a traditionally low completion rate, and concluded that a completion rate of 90 percent can be achieved without universal supervision therapy.

Pablos-Mendez et al. Global surveillance for antituberculosis-drug resistances, 1994-1997. New England Journal of Medicine. 338(23):1641, June 4, 1998.
This article discusses research surveying drug resistance to four first-line antituberculosis drugs in 35 countries between 1994 and 1997. The authors found that among patients with no prior treatment a median of 9.9 percent of M. tuberculosis strains were resistant to at least one drug.

Optimize AIDS surveillance by sharing databases. AIDS Alert. 13(6):67, June 1998.
This article examines a two-year New York City project that combined the city health department's AIDS and tuberculosis databases, optimizing epidemiological information for both diseases. During this project, 700 unknown cases of HIV and TB co-infection were discovered. Linking the databases provided more accurate epidemiological information, which states may find cost-effective.

Reporting of co-infection still limited. AIDS Alert. 13(6):68, June 1998.
This article focuses on the concern that only 50 percent of cases of TB in the presence of HIV infection are being reported by health departments. Health experts are concerned about the high incidence of TB among U.S. residents born outside of the United States and about the relationship between HIV and TB.

Tuberculosis morbidity-United States, 1997. Morbidity and Mortality Weekly Report. 47(13):253-257, April 10, 1998.
This CDC report summarizes national TB surveillance data for 1997 and compares it with similar data for previous years. The findings indicate that, although the overall number of TB cases continued to decrease, the numbers of reported cases differed by geographic area and population characteristics.

Chaulk, C. P. and V. A. Kazandjian. Directly observed therapy for treatment completion of pulmonary tuberculosis. Journal of the American Medical Association. 279(12):943, March 25, 1998.
This article discusses the findings of the Public Health Tuberculosis Guidelines Panel about the relative efficacy of directly observed therapy (DOT) for treatment completion of pulmonary TB. The panel's recommendations are that DOT be used to ensure adequate completion of TB treatment and that timely case identification, associate and contact investigations, and effective prevention programs for high-risk populations also are critical ingredients for successful TB control.

Stephenson J. TB prophylaxis and HIV. Journal of the American Medical Association. 279(11):818, March 18, 1998.
This journal article discusses the results of a study of nearly 1,600 patients in four nations who are co-infected with M. tuberculosis and HIV who were either on short-course therapy or a longer regimen. The study determined that patients were more likely to complete the short-course therapy, which was as safe and effective as the longer regimen.

Valway et al. An outbreak involving extensive transmission of a virulent strain of Mycobacterium tuberculosis. New England Journal of Medicine. 338(10):633, March 5, 1998.
This article focuses on a CDC study of an outbreak from 1994 to 1996 of a virulent strain of tuberculosis in rural communities in two counties in Tennessee and Kentucky.

Heymann, S. J., R. Sell and T. F. Brewer. The influence of program acceptability on the effectiveness of public health policy: A study of directly observed therapy for tuberculosis. American Journal of Public Health. 88(3):442, March 1998.
This journal article focuses on the relationship between directly observed therapy and successful completion of therapy in patients with TB.

Ostroff, S. M. and P. Kozarsky. Emerging infectious diseases and travel medicine. Infectious Disease Clinics of North America. 12(1):231-41, March 1998.
This journal article discuses the relationship between travel and emerging infectious diseases, including TB. Global travel of individuals, populations, and products is one of the major factors associated with the emergence and re-emergence of infectious diseases.

Carroll, D. Short-course TB prophylaxis effective in HIV-infected individuals. NIAID News. February 11, 1998.
This article discusses the results of an international study, sponsored by the National Institute of Allergy and Infectious Diseases, the CDC, and the Pan American Health Organization, which indicates that a two-month, short-course therapy provides an effective alternative to the current year-long treatment for patients co-infected with HIV and TB.

Stephenson M. Tuberculin skin testing in children not important in low-risk cases. Infectious Diseases in Children. 11(2):13, February 1998.
This article explains that tuberculin skin tests for children at low risk of infection have not proven effective and may even be harmful due to a high rate of false positive results.

Wenzel, R. P. and M. B. Edmond. Tuberculosis infection after bronchoscopy. Journal of the American Medical Association. 278(13):1111, October 1, 1997.
This opinion piece asserts that implementation and monitoring of adequate guidelines for bronchoscope cleaning and disinfection are essential to the control of TB in the United States.

Whalen et al. A trial of three regimens to prevent tuberculosis in Ugandan adults infected with the human immunodeficiency virus. New England Journal of Medicine. 337(12):801, September 18, 1997.
This journal article discusses the results of a study of more than 2,700 HIV-positive Ugandan adults. The authors found that six months of isoniazid therapy reduced by 67 percent the risk of TB in HIV-positive adults who also tested positive for purified protein derivative-at least in the short term.

Moore et al. Trends in drug-resistant tuberculosis in the United States, 1993-1996. Journal of the American Medical Association. 278(10):833, September 10, 1997.
This journal article analyzes data collected between 1993 and 1996 that indicate that resistance to TB-fighting drugs in the United States remains a serious public health concern.

Singleton et al. Long-term hospitalization for tuberculosis control. Journal of the American Medical Association. 278(10):838, September 10, 1997.
Statistics from this study of inpatient TB treatment in Massachusetts show success in treating patients with complicated medical histories, including multi-drug resistant TB, HIV infection, and injection drug use. The authors conclude that long-term hospitalization is a necessary component of a comprehensive TB control program that individualizes TB treatment and applies the least restrictive means to complete treatment.

Oscherwitz et al. Detention of persistently nonadherent patients with tuberculosis. Journal of the American Medical Association. 278(10):843, September 10, 1997.
This journal article analyzes attempts to detain 67 TB patients who were chronically nonadherent to treatment in 12 California counties and reflects the difficulty of providing treatment to such individuals.

Moreno et al. Isoniazid preventive therapy in human immunodeficiency virus-infected persons. Archives of Internal Medicine. 157(15):1729, August 11, 1997.
This journal article discusses the long-term benefits of isoniazid prophylaxis in patients co-infected with HIV and Mycobacterium tuberculosis.

Tuberculosis morbidity-United States, 1996. Morbidity and Mortality Weekly Report. 46(30):695, August 1, 1997.
This article reports that between 1995 and 1996 the number of TB cases in the United States declined. When this article was published, this number was the lowest it had been since data were first collected in 1953. Despite this reduction, there were still more TB cases than called for under the goal of elimination by 2010.

Gordin et al. A controlled trial of isoniazid in persons with anergy and human immunodeficiency virus infection who are at high risk for tuberculosis. New England Journal of Medicine. 337(5):315, July 31, 1997.
This article discusses the findings of a study between 1991 and 1996 of more than 500 HIV-infected patients at risk for TB to determine the efficacy of six months of isoniazid prophylaxis.

Zuber et al. Long-term risk of tuberculosis among foreign-born persons in the United States. Journal of the American Medical Association. 278(4):304, July 23-July 30, 1997.
This article discusses CDC reports that the majority of TB cases among foreign-born persons in the U.S. can be attributed to imported Mycobacterium TB infection. The detection of active TB should be a primary focus in foreign-born populations in the U.S., and greater action against TB worldwide is necessary to eliminate TB in the U.S.

Cookson, S. T. and W. R. Jarvis. Prevention of nosocomial transmission of Mycobacterium tuberculosis. Infectious Disease Clinic of North America. 11(2):385-409, June 1997.
This article discusses the increased risk of nosocomial and occupational transmission of infectious M. tuberculosis due to the recent resurgence of TB and the ongoing HIV epidemic.

Performance evaluation programs for determining HIV-1 viral loads, testing for HIV p24 antigen, and identifying Mycobacterium tuberculosis using nucleic acid amplification tests. Journal of the American Medical Association. 277(10):76, March 12, 1997.
This article discusses CDC programs to evaluate the performance of laboratories that do viral load testing for HIV, HIV antigen p24 testing, and TB nucleic acid amplification testing.

Brewer et al. Evaluation of tuberculosis control policies using computer simulation. Journal of the American Medical Association. 276(23):1898, December 18, 1996.
This article discusses a computer simulation model used to project the impact of five TB control measures, including a BCG vaccine program, more effective preventive therapy, more effective treatment, and wider use of treatment.

Moser et al. Characteristics of foreign-born Hispanic patients with tuberculosis-eight U.S. counties bordering Mexico, 1995. Morbidity and Mortality Weekly Report. 45(47):1032, November 29, 1996.
In this article, the authors study the immigration patterns of Hispanic foreign-born TB patients in the United States and compare drug resistance rates among these patients with drug resistance rates among U.S.-born non-Hispanic patients now living in the same regions of the United States. The authors conclude that TB surveillance efforts should be increased in non-border regions of Mexico.

Clinical update: impact of HIV protease inhibitors on the treatment of HIV-infected tuberculosis patients with rifampin. Morbidity and Mortality Weekly Report. 45(42):921-925, October 25, 1996.
This CDC report describes approaches for managing patients who are candidates for or who are undergoing protease inhibitor therapy when TB is diagnosed. It presents interim recommendations for managing these patients until additional data are available and formal guidelines issued.

Frieden et al. A multi-institutional outbreak of highly drug-resistant tuberculosis. Journal of the American Medical Association. 276(15):1229, October 15, 1996.
This study features an analysis of every case of TB strain W-a multi-drug resistant strain-in New York City between 1990 and 1993, the likely location of transmission, and the clinical outcome of each case.

Bradford, W. Z., J. N. Martin and A. L. Reingold. The changing epidemiology of acquired drug-resistant tuberculosis in San Francisco, USA. Lancet. 348(9032):928, October 5, 1996.
This journal article examines TB drug resistance in San Francisco, a city that has had an effective TB control program. Examining all reported TB cases in San Francisco between 1985 and 1994, the authors associate TB drug resistance with AIDS, non-compliance with therapy, and gastrointestinal symptoms. They conclude that the increasing prevalence of HIV/TB co-infection can be attributed to the increase in acquired drug resistance in San Francisco.

Blower, S.M., P. M. Small and P. C. Hopewell. Control strategies for tuberculosis epidemics: new models for old problems. Science. 273(5274):497, July 26, 1996.
This article presents a theoretical framework for designing effective TB control strategies and for determining treatment levels to eradicate TB. Using a mathematical model that estimates the disease's pathogenesis and incorporating the population level effects of chemoprophylaxis and treatment, the authors conclude that to control TB, treatment failure rates must be lower in developing countries than in industrialized countries.

Multidrug-resistant tuberculosis outbreak on an HIV Ward-Madrid, Spain, 1991-1995. Morbidity and Mortality Weekly Report. 45(16):330-3, April 26, 1996.
This CDC report summarizes the findings of an investigation into nosocomial transmission of multidrug-resistant TB on an HIV ward in Madrid.

Kenyon et al. Transmission of multidrug resistant Mycobacterium tuberculosis during a long airplane flight. New England Journal of Medicine. 334(15):933, April 11, 1996.
This journal article discusses a study by CDC researchers into an incident in which passengers and flight crew were exposed to infectious multi-drug resistant TB by a passenger who traveled from Honolulu to Chicago and from Chicago to Baltimore in April and back in May 1994.

Friedman et al. Tuberculosis, AIDS, and death among substance abusers on welfare in New York City. New England Journal of Medicine. 334(13):828, March 28, 1996.
Based on a New York City study of 858 welfare recipients who abused drugs or alcohol, this article reports on the relationship of these characteristics to the subjects' tendency to become infected with TB and/or HIV. The authors conclude that for AIDS and TB programs to be effective among indigent substance abusers, health services must be integrated into welfare delivery.

Surveillance of tuberculosis and AIDS co-morbidity-Florida, 1981-1993. Morbidity and Mortality Weekly Report. 45(2):38-41, January 19, 1996.
This CDC report summarizes an analysis of the AIDS and TB registry match conducted by the Florida Health and Rehabilitative Services Department to evaluate the quality of AIDS and TB surveillance data and to enhance completeness of reporting for both surveillance systems.

Kelly-Rossini, L., D. C. Perlman and D. J. Mason. The experience of respiratory isolation for HIV-infected persons with tuberculosis. Journal of the Association of Nurses in AIDS Care. 7(1):29, January-February 1996.
This journal article discusses a New York City study of the feelings and coping methods of TB patients who were isolated for treatment.

Tuberculosis among foreign-born persons who had recently arrived in the United States-Hawaii, 1992-1993, and Los Angeles County, 1993. Morbidity and Mortality Weekly Report. 44(38):703-707, September 29, 1995.
This CDC report summarizes a review of foreign-born persons in whom TB was diagnosed in Hawaii between 1992 and 1993 and in Los Angeles County during 1993. It assesses the impact of TB screening on foreign-born persons residing in the United States for less than one year at the time of diagnosis.

Laboratory practices for diagnosis of tuberculosis-United States, 1994. Morbidity and Mortality Weekly Report. 44(31):587-589, August 11, 1995.
This CDC report indicates that for a number of TB cases treatment may be delayed because at least 54 percent of laboratories testing for TB must refer culture isolates to another laboratory for complete analysis. The report summarizes information that laboratories reported to federally approved proficiency testing programs about the laboratories' practices for M. tuberculosis.

Wolfe et al. Tuberculosis knowledge among New York City injection drug users. American Journal of Public Health. 85(7):985, July 1995.
This article discusses a study of participants in methadone maintenance treatment programs and their knowledge of TB.

Chaffee, B. H., S. Moehring and S. Pruden. HIV, sexually transmitted disease, and tuberculosis testing at community sites in upstate New York. American Journal of Public Health. 85(6):867, June 1995.
This journal article discusses the principle of taking HIV, TB, and syphilis screening into the places where people at risk for these infections can be found. The authors believe that with this strategy they reached more people than similar clinic-based services would have.

Coincidence of HIV/AIDS and tuberculosis-Chicago, 1982-1993. Morbidity and Mortality Weekly Report. 44(11):227, March 24, 1995.
This CDC report describes the overall occurrence of TB in Chicago during 1982-1993 and characterizes the co-incidence of TB and HIV/AIDS in Chicago during 1989-1993.

Exposure of passengers and flight crew to Mycobacterium tuberculosis on commercial aircraft, 1992-1995. Morbidity and Mortality Weekly Report. 44(08):137-140, March 3, 1995.
This report summarizes CDC and state health department investigations of in-flight exposures to TB and provides guidance about notification of passengers and flight crew if exposure to TB occurs during commercial air travel.

U.S. paying high price for HIV and TB epidemics. AIDS Alert. 10(3):43, March 1995.
This article discusses a national study of hospital costs for treating HIV and TB, which found that co-infection significantly boosted the morbidity and cost of healthcare in young adults.

Proportionate mortality from pulmonary tuberculosis associated with occupations-28 states, 1979-1990. Morbidity and Mortality Weekly Report. 44(01):4-19, January 13, 1995.
This report presents the findings of a study to identify occupations associated with increased risk for TB mortality.

Multidrug-resistant tuberculosis in a hospital-Jersey City, New Jersey, 1990-1992. Morbidity and Mortality Weekly Report. 43(22):417-419, June 10, 1994.
To characterize the epidemiologic features of persons with drug-resistant TB, this CDC study compared a New Jersey hospital's rates of drug-resistant TB with previously reported rates, rates for other New Jersey cities, and rates for the state.

Epidemiologic notes and reports: expanded tuberculosis surveillance and tuberculosis morbidity-United States, 1993. Morbidity and Mortality Weekly Report. 43(20):361-366, May 27, 1994.
This CDC report summarizes final surveillance data for 1993, compares findings with previous years, and provides information on expanded surveillance.

Current trends: self-reported tuberculin skin testing among Indian Health Service and Federal Bureau of Prisons dentists. Morbidity and Mortality Weekly Report. 43(11):209-11, March 25, 1994.
Essential to effective TB control in healthcare settings are surveillance of healthcare workers for TB and assessment of TB transmission through routine periodic screening with tuberculin skin tests (TSTs). This CDC report summarizes the data from a survey to characterize the TST practices of federal dentists.

Estimates of future global tuberculosis morbidity and mortality. Morbidity and Mortality Weekly Report. 42(49), December 17, 1993.
The global incidence of TB is expected to increase during the next ten years because of the interaction between the TB and HIV epidemics. This report uses TB data collected by the World Health Organization to estimate the future global impact of TB and to assess HIV's contribution thereto.

Tuberculosis among pregnant women-New York City, 1985-1992. Morbidity and Mortality Weekly Report. 42(31):605, 611-612, August 13, 1993.
TB may be an increasing problem among reproductive-aged women. This CDC report summarizes a study to determine the prevalence of active TB during pregnancy. The study reviewed medical records of two public hospitals in New York City from 1985 through 1992.

Outbreak of multidrug-resistant tuberculosis in a hospital. Morbidity and Mortality Weekly Report. 42(22), June 11, 1993.
This report summarizes an epidemiologic investigation by hospital infection control, infectious diseases, and employee services staff into a multidrug-resistant TB (MDR-TB) outbreak in a New York hospital. While MDR-TB affected 43 of 198 TB patients, this report presents information only for the 32 diagnosed between 1991 and 1992, of whom 31 had been patients on the HIV ward.

Tuberculosis prevention in drug-treatment centers and correctional facilities-selected U.S. sites, 1990-1991. Morbidity and Mortality Weekly Report. 42(11):210-213, March 26, 1993.
This CDC report summarizes the results of a demonstration project during1990-1991 to evaluate the feasibility of onsite screening for TB infection among clients of drug treatment centers and inmates of correctional facilities.

Probable transmission of multidrug-resistant tuberculosis in a correctional facility-California. Morbidity and Mortality Weekly Report. 42(03):48-51, January 29, 1993.
This CDC report presents the findings of an investigation into possible nosocomial transmission of multidrug-resistant TB from inmates to staff of a California prison.