Journal of Community Health

, Volume 20, Issue 1, pp 29–57 | Cite as

Tuberculosis: A health education imperative returns

  • George L. WhiteJr.
  • Beth Hogan Henthorne
  • S. Eugene Barnes
  • Jay T. Segarra


The ominous resurgence of tuberculosis after many years of containment necessitates a review of the various factors responsible. An intense collaborative effort is needed to avoid potentially catastrophic consequences of the new epidemic. To provide a basis for health education recommendations, the factors contributing to the resurgence of tuberculosis, the nature of the current epidemic, and past health education efforts are reviewed. Further, an expanded Health Belief Model is offered as a foundation to guide educational campaigns.


Public Health Tuberculosis Health Promotion Disease Prevention Health Education 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kochi, A. Government intervention programs in HIV/tuberculosis infection. Outline of guidelines for national tuberculosis control programs in view of the HIV epidemic.Bull Int Union Tuber Lung Dis 1991; 66:33–6.Google Scholar
  2. 2.
    Trubo R. The new TB: conspicuous consumption.Harvard Health Letter 1993; 18:6–8.Google Scholar
  3. 3.
    Centers for Disease Control.Core Curriculum on Tuberculosis, Second Edition. Atlanta:CDC, 1991.Google Scholar
  4. 4.
    Centers for Disease Control. Initial therapy for tuberculosis in the era of multi-drug resistance: Recommendations of the advisory council for the elimination of tuberculosisMMWR 1993; 42:(RR-7).Google Scholar
  5. 5.
    Davidson PT, Le HQ. Drug Treatment of tuberculosis—1992.Drugs 1992; 43:651–73.Google Scholar
  6. 6.
    Centers for Disease Control. National action plan to combat multidrug-resistant tuberculosis — meeting the challenge of multi-resistant tuberculosis: Summary of a conference—management of persons exposed to multidrug-resistant tuberculosis.MMWR 1992; 41:(RR-11)6–25.Google Scholar
  7. 7.
    Barnes PF, Barrows SA. Tuberculosis in the 1990s.Ann Intern Med 1993; 119:400–410.Google Scholar
  8. 8.
    Frieden TR, Sterling T, Pablos-Mendez A, Kilburn JO, Cauthen GM, Dooley SW. The emergence of drug-resistant tuberculosis in New York City N.Y.New Engl J Med 1993; 328:521–526.Google Scholar
  9. 9.
    Barnes SE, White GL Jr, Sharkey PW, Parkman CJ. Pulmonary tuberculosis resurgence after near eradication.Clinician Reviews 1992; 3:69–93.Google Scholar
  10. 10.
    Boom BR, Murray CJL. Tuberculosis: commentary on a reemergent killer.Science 1992; 257:10555–1064.Google Scholar
  11. 11.
    American Thoracic Society and Centers for Disease Control—Joint position paper. Mycobacterioses and the acquired immunodeficiency syndrome.AM Rev Respir Dis 1987; 136:492–6.Google Scholar
  12. 12.
    Beck-Saque C, Dooley SW, Hutton MD, Otten J, Breeden A, Crawford JT, Pitchenik AE, Woodley C, Cauthen G, Jarvis WR. Hospital Outbreak of Multi-drug resistant Mycobacterium tuberculosis infections.JAMA 1992; 268:1280–1286.Google Scholar
  13. 13.
    Goldsmith MF, Medical exorcism required as revitalized revenant of tuberculosis haunts and harries the land.JAMA 1992; 268:174–175.Google Scholar
  14. 14.
    Miller AB, Respiratory manifestations of AIDS.Br J Hosp Med 1988; 39:204–15.Google Scholar
  15. 15.
    Collins, FM. Mycobacterial diseases immunosuppression, and acquired immunodeficiency syndrome.Clin Microbiol Rev 1989; Oct:360–377.Google Scholar
  16. 16.
    Dooley SW, Villarino ME, Lawrence M, Salinas L, Amil S, Rullan JV, Jarvis WR, Bloch AB, Cauthen GM. Nosocomial transmission of tuberculosis in a hospital unit for HIV-infected patients.JAMA 1992; 267:2632–2534.Google Scholar
  17. 17.
    Jordan T, Lewit E, Montgomery R, Reichman L. Isoniazid as preventive therapy in HIV-infected intravenous drug abusers.JAMA 1991; 265:2987–2991.Google Scholar
  18. 18.
    Sepkowitz KA. Tuberculosis and the health care worker: A historical perspective.Ann Intern Med 1994; 120:71–79.Google Scholar
  19. 19.
    Daley CL, Small PM, Schecter GF, Schoolnik GK, Mcadam RA, Jacobs WR Jr, Hopewell PC. An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus—an analysis using restriction-fragment length polymorphisms.N. Engl J Med 1992; 326:231–235.Google Scholar
  20. 20.
    Fischl MA, Uttamchandani RB, Daikos GL, Poblete RB, Moreno JN, Reyes RR, Boota AM, Thompson LM, Cleary TJ, Lai S. An outbreak of tuberculosis caused by multiple drug-resistant tubercle bacilli among patients with HIV infection.Ann Intern Med 1992; 117:177–183.Google Scholar
  21. 21.
    Chaisson, RE. Mycobacterial infections and HIV.Current Opinion in Infectious Disease 1993; 6:237–243.Google Scholar
  22. 22.
    Pedro-Botet ET Jr, Gutierrez J, Miralles R, Coll J, Rubies-Prat J. Pulmonary tuberculosis in HIV-infected patients with normal chest radiographs.Aids 1992; 6:91–93.Google Scholar
  23. 23.
    Stead WW, Dutt AK. Tuberculosis in the elderly.Semin Respir Infect 1988; 4:189–197.Google Scholar
  24. 24.
    Myers JA. Tuberculosis among persons over fifty years of age.Geriatrics 1948; 4:27–39.Google Scholar
  25. 25.
    Handwerger S, Mildvan D, Senie R, McLinley FW, Tuberculosis and the acquired immunodeficiency syndrome at a New York City Hospital.Chest 1987; 91:176–80.Google Scholar
  26. 26.
    Ferrini AF, Ferrini RL.Health in the Later Years. Madison: Brown and Benchmark, 1992, 423–439.Google Scholar
  27. 27.
    Myers JA. Tuberculosis in the elderly—a threat to children.Geriatrics 1946; 1:456.Google Scholar
  28. 28.
    Manning A. Disgraceful rise in tuberculosis.USA Today 1993; May 20: (Thurs)D-1.Google Scholar
  29. 29.
    Abernathy RS. Tuberculosis in children and its arrangementSemin Respir Infect 1989; 4:232–42.Google Scholar
  30. 30.
    Nolan RJ Jr. Childhood tuberculosis in North Carolina: A study of the opportunities for intervention in the transmission of tuberculosis to children.Am J Public Health 1986; 76:26–30.Google Scholar
  31. 31.
    Starke JR. Modern approach to the diagnosis and treatment of tuberculosis in children.Pediatr Clin North Am 1988; 35:441–64.Google Scholar
  32. 32.
    Kendig EL Jr. Tuberculin testing in the young.Compr Ther 1986; 12:66–70.Google Scholar
  33. 33.
    Ovsiankina ES, Kafakova GA. Anketirovanie v vyiavlenii faktorov riska tuberkulezno: i infektsii u dete: i i podrostkov shkol-internatov. (Questionnaire of detecting the risk of tuberculosis infection in children and adolescents in boarding schools)Probl Tuberk 1991; 12:10–12 (Russian).Google Scholar
  34. 34.
    Haverkos HW. Infectious disease and drug abuse. Prevention and treatment in the drug abuse treatment system.J. Sust Abuse Treat 1991; 8:269–275.Google Scholar
  35. 35.
    Bearak B. (Los Angeles Times), Waiting to die at the ‘AIDS hotel’.Arkansas Democrat Gazette 1993; Aug 29: J1–3.Google Scholar
  36. 36.
    Yu GP, Hsieh CC, Peng J. Risk factors associated with the prevalence of pulmonary tuberculosis among sanitary workers in Shanghai.Tubercle 1988; 69:105–12.Google Scholar
  37. 37.
    Rikimaru T, Tanaka Y, Yokoyama T, Futapami E, Ginnouchi Y, Ichikawa Y, Oizumi K. Active bronchial tuberculosis—a clinical study of 36 cases.Kekkaku 1991; 8:511–6 (Japanese).Google Scholar
  38. 38.
    Xie ZY, A study of blood rifampin concentration in smoking and non-smoking healthy individuals and in patients with tuberculosis.Chung-hua Chieh Ho Ho Hu Hsi Tsa Chih (Chinese Journal of Tuberculosis and Respiratory Diseases) 1989 12:3–5,60.Google Scholar
  39. 39.
    Center For Disease Control. Prevention and control of tuberculosis in migrant farm workers.MMWR 1992; 41:(RR-10)1–15.Google Scholar
  40. 40.
    Brudney K, Dobkin J. Resurgent tuberculosis in New York City: human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs.Journal of Public Health Policy 1992; 13:435–450.Google Scholar
  41. 41.
    McAdam JM, Brickner PW, Scharer LL, Crocco JA, Duff AE. The spectrum of tuberculosis in a New York city men's shelter clinic (1982–1988).Chest 1990; 97:798–805.Google Scholar
  42. 42.
    Anderson KM, Keith EP, Norstead SW. Tuberculosis screening in Washington State male correctional facilities.Chest 1986; 89:817–21.Google Scholar
  43. 43.
    Cowley G, Leonard EA, Hager M. Tuberculosis, a deadly return.Newsweek 1992; 16:53–57.Google Scholar
  44. 44.
    Snider DE Jr, Salina L, Kelly GD. Tuberculosis: an increasing health problem among minorities in the United States.Public Health Rep 1989 104:646–53.Google Scholar
  45. 45.
    Ryan, F.The Forgotton Plague, How the Battle Against Tuberculosis was Won and Lost. Boston: Little, Brown and Company, 1992, p. 404.Google Scholar
  46. 46.
    Manning A. CDC studies four fliers who had TB.USA Today 1993; 22: (Tues)A-1,2.Google Scholar
  47. 47.
    Woo J. Tuberculosis is reviving concern on legality of forced treatment.Wall Street Journal 1993; Feb. 16 (Tues): B-7.Google Scholar
  48. 48.
    Mayo Foundation For Medical Education. Tuberculosis, a ticking time bomb.Mayo Clinic Health Letter 1993; April 11:1–3.Google Scholar
  49. 49.
    Health (staff writer). Doctors Fail the TB test.Health 1993; 7:10,12.Google Scholar
  50. 50.
    Calder RA, Duclos P, Wilder MH, Pryor VL, Scheel WJ. Mycobacterium tuberculosis transmission in a health clinic.Bull Int Union Tuberc Lung Dis 1991; 66:103–6.Google Scholar
  51. 51.
    Khudshina TA, Maslakova MG, Dmitrienko LV. O gruppakh riska azbolevaniia tuberkulezom (Groups with the risk of tuberculosis).Prob Tuberk 1991; 8:25–7 (Russian).Google Scholar
  52. 52.
    Zinsser H,Rats, Lice and History. Boston: Atlantic Monthly Press, 1935, pp 1–301.Google Scholar
  53. 53.
    Centers For Disease Control. National action plan to combat multidrug-resistant tuberculosis. Recommendations and reports.MMWR 1992; 41:(RR-11)5–48.Google Scholar
  54. 54.
    Jereb JA, Kelly GD, Dooley SW Jr, Cauthen GM, Snider DE Jr, Tuberculosis morbidity in the United States: final data 19 90.MMWR CDC Surveillance Survey 1991; 40:23–7.Google Scholar
  55. 55.
    Teller ME,The Tuberculosis Movement—A Public Health Campaign in the Progressive Era. New York: Greenwood Press, 1988, pp 15–926.Google Scholar
  56. 56.
    Ramazzini B,Diseases of Workers: The Latin Text of 1713 (revised translation and notes by Wilmer Cave Wright. Chicago: University of Chicago Press, 1940. As cited in Teller ME.The Tuberculosis Movement—A Public Health Campaign in the Progressive Era. New York: Greenwood Press, 1988.Google Scholar
  57. 57.
    Dublin L.A 40 Year Campaign Against Tuberculosis. New York: Metropolitan Life Insurance Company, 1952, pp 2–203.Google Scholar
  58. 58.
    Centers For Disease Control. Prevention and control of tuberculosis in U.S. communities with at-risk minority populations. Recommendations of the Advisory council for the Elimination of Tuberculosis.MMWR 1992; 41: (RR5)1–11.Google Scholar
  59. 59.
    Hales D,An Invitation to Health. Redwood City, Ca: Benjamin Cummings Publishing Company, Inc., 1992, pp 8–12.Google Scholar
  60. 60.
    Russell RD,Health Education, Sixth Edition. Washington, D.C.: National Education Association, 1975, pp 88–101.Google Scholar
  61. 61.
    Mausner, JS, Bahn, AK.Epidemiology, and Introductory Text. Philadelphia: WB Saunders Company, 1974, pp 9–12.Google Scholar

Copyright information

© Human Sciences Press, Inc 1995

Authors and Affiliations

  • George L. WhiteJr.
    • 1
  • Beth Hogan Henthorne
    • 2
  • S. Eugene Barnes
    • 3
  • Jay T. Segarra
    • 4
  1. 1.Center for Community HealthUniversity of Southern MississippiHattiesburg
  2. 2.Owner of Practice InnovationsHattiesburg
  3. 3.Dept. of HPELS, College of EducationThe University of South AlabamaMobile
  4. 4.Pulmonary Section, Department of Medicine at Kessler Medical CenterKeesler Air Force Base

Personalised recommendations