Inner-city ZIP codes had the highest rates of tuberculosis, with incidence rates decreasing away from the inner city. Two inner-city ZIP codes had annual rates greater than 120 cases per 100,000, and eight ZIP codes had annual rates between 47 and 87.5 cases per 100,000. Drug resistance among Grady's tuberculosis patients during the study period was relatively low compared to cities such as New York and Miami, which have had high rates of multidrug-resistant tuberculosis. Public health interventions, increased funding for tuberculosis control efforts, implementation of directly observed therapy and prevention of hospital infections led to the disease's decline in the 1990s and has raised new discussion about the feasibility of the U.S. Public Health Service goal of eliminating tuberculosis by 2010. Our experience at Grady, a public, inner-city hospital, contrasts starkly with nationally declining trends in tuberculosis.
Tuberculosis remains a serious problem in urban areas.
These findings indicate a severe need for concentrated efforts and resources in urban areas if tuberculosis control and elimination are to be achieved in the United States. Copyright Emory University, 1999. All Rights Reserved.