Public health workers need to be sensitive to this issue and minimize disclosure of patient identity as much as possible. So in Georgia we are at a point of decreasing incidence but increasing treatment challenges. With regards to skills, personnel need to be trained to suspect and recognize TB and, more importantly, to take action when TB is suspected. We need to emphasize knowing who to ask for help and insist that personnel seek help when it is needed. New, shorter treatment regimens are always being evaluated but until they are available other innovative treatment strategies are needed.
Incentives can be a powerful motivator for maintaining adherence.
The cohort offered this incentive was nearly 7 times more likely to complete at least 40 visits as was a similar historical control group. It is also important for TB program personnel to collaborate with other groups. The other thing that needs to be emphasized is the maintenance and improvement of the TB control program infrastructure. There has been a decrease in public health spending which means a decline in the capacity to promote and maintain personnel and programs. Worse there is a culture of indifference within some TB control programs in Georgia which can damage the relationship with the public and with collaborators in other areas of the public health system.