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Cegielski JP, Griffith DE, McGaha PK, et al. Eliminating tuberculosis one neighborhood at a time. Am J Public Health. 2014;104:S214-33doi: 10.2105/AJPH.2012.300781r.
Cegielski, J. P., Griffith, D. E., McGaha, P. K., Wolfgang, M., Robinson, C. B., Clark, P. A., Hassell, W. L., Robison, V. A., Walker, K. P., & Wallace, C. (2014). Eliminating tuberculosis one neighborhood at a time. American journal of public health, 104S214-33. https://doi.org/10.2105/AJPH.2012.300781r
Cegielski, J Peter, et al. "Eliminating tuberculosis one neighborhood at a time." American journal of public health vol. 104 (2014): S214-33. doi: https://doi.org/10.2105/AJPH.2012.300781r
Cegielski JP, Griffith DE, McGaha PK, Wolfgang M, Robinson CB, Clark PA, Hassell WL, Robison VA, Walker KP, Wallace C. Eliminating tuberculosis one neighborhood at a time. Am J Public Health. 2014 Apr;104:S214-33. doi: 10.2105/AJPH.2012.300781r. PMID: 24899457; PMCID: PMC5319210.
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Am J Public Health. 2014 Apr;104:S214-33. doi: 10.2105/AJPH.2012.300781r.

Eliminating tuberculosis one neighborhood at a time.

American journal of public health

J Peter Cegielski, David E Griffith, Paul K McGaha, Melanie Wolfgang, Celia B Robinson, Patricia A Clark, Willis L Hassell, Valerie A Robison, Kerfoot P Walker, Charles Wallace

Affiliations

  1. J. Peter Cegielski, Melanie Wolfgang, and Valerie A. Robison are with the Centers for Disease Control and Prevention (CDC), Atlanta, GA. David E. Griffith, Patricia A. Clark, and Willis L. Hassell are with the University of Texas Health Science Center, Tyler. Paul K. McGaha and Celia B. Robinson are with the Texas Department of State Health Services, Tyler. Kerfoot P. Walker Jr is with the Smith County Public Health District, Tyler. Charles Wallace is with the Texas Department of State Health Services, Austin.

PMID: 24899457 PMCID: PMC5319210 DOI: 10.2105/AJPH.2012.300781r

Abstract

OBJECTIVES: We evaluated a strategy for preventing tuberculosis (TB) in communities most affected by it.

METHODS: In 1996, we mapped reported TB cases (1985-1995) and positive tuberculin skin test (TST) reactors (1993-1995) in Smith County, Texas. We delineated the 2 largest, densest clusters, identifying 2 highest-incidence neighborhoods (180 square blocks, 3153 residents). After extensive community preparation, trained health care workers went door-to-door offering TST to all residents unless contraindicated. TST-positive individuals were escorted to a mobile clinic for radiography, clinical evaluation, and isoniazid preventive treatment (IPT) as indicated. To assess long-term impact, we mapped all TB cases in Smith County during the equivalent time period after the project.

RESULTS: Of 2258 eligible individuals, 1291 (57.1%) were tested, 229 (17.7%) were TST positive, and 147 were treated. From 1996 to 2006, there were no TB cases in either project neighborhood, in contrast with the preintervention decade and the continued occurrence of TB in the rest of Smith County.

CONCLUSIONS: Targeting high-incidence neighborhoods for active, community-based screening and IPT may hasten TB elimination in the United States.

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