, Volume 20, Issue 1, pp 15-28

A new role for community organizations in the prevention and control of tuberculosis

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The resurgence of tuberculosis in the United States has forced public health officials to reconsider the most appropriate strategies for its prevention and control. Many recent reports have suggested that the priority of public health programs should be to identify those with active tuberculosis and ensure that these individuals complete medical treatment. While this goal is necessary, it is not sufficient. First, it does not acknowledge the difficulty that health care agencies have in contacting and engaging those at highest risk of active tuberculosis. Second, it fails to address the broader social factors that have contributed to the reemergence of epidemic tuberculosis. This report describes an alternative strategy in which community organizations play a significant role in TB prevention and control. An examination of two previous efforts, the community TB programs of the first part of this century and the community AIDS prevention programs of the last decade, provides suggestions for specific activities that community organizations can carry out in order to control TB. To fulfill this expanded role, community organizations will need new resources, technical assistance, and training.

This work was supported by the Aaron Diamond Foundation and Hunter College/CUNY. Thanks to Steven M. Safyer, MD, Thomas Frieden, MD, George DiFerdinando, MD, Val Kanuha, MSW, and Diana Silver, MPH, for their helpful comments. The views represented here are the author's.