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Tuberculosis and the older patient

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  04 May 2010

S Haney  and
SC Stenton
S Haney
Affiliation:
Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, UK
SC Stenton*
Affiliation:
Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, UK
*
Address for correspondence: Dr SC Stenton, Consultant Physician and Senior Lecturer, Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK. Email: Chris.Stenton@nuth.nhs.uk
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Summary

Tuberculosis (TB) rates in the UK have increased by about 25% over the last 20 years. About 12% of cases occur in those over 65. Their diagnosis and treatment is similar to that of younger patients, but their presentation is often atypical, diagnosis is often delayed, there is a higher frequency of treatment side-effects and there is greater potential for drug interactions. Mortality increases markedly with age and more than half of those aged 80 years or more die before completing treatment. About 75% of TB in older patients is due to reactivation of latent disease acquired in childhood. The risk of reactivation is particularly increased by human immunodeficiency virus (HIV) infection and anti-tumour necrosis factor (anti-TNF) medication. Active disease spreads by the inhalation of airborne droplets, particularly in enclosed environments such as nursing homes. Interferon gamma release assays (IGRAs) are an important new development in recognizing latent infection. They should allow better targeting of treatment in those with recently acquired infection, or who are at risk of reactivation. With appropriate effort it should be possible to substantially reduce TB rates to fewer than 1 per million per year, the current US target.

Keywords

tuberculosisageinginterferon gamma release assayepidemiologymanagement
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 20 , Issue 2 , May 2010 , pp. 81 - 91
Copyright
Copyright © Cambridge University Press 2010

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References

1Hayward, A, Watson, J. Tuberculosis in England and Wales 1982–1993: notifications exceeded predictions. Communicable Dis Rep 1995; 5: R29–33.Google ScholarPubMed
2Tuberculosis in the UK: Annual report on tuberculosis surveillance in the UK 2009. London: Health Protection Agency Centre for Infections, 2009.Google Scholar
3Dye, C, Scheele, S, Dolin, P, Pathania, V, Raviglione, M. Global burden of tuberculosis. Estimated incidence, prevalence, and mortality by country. JAMA 1999; 282: 677–86.CrossRefGoogle ScholarPubMed
4National Collaborating Centre for Chronic Conditions. Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control. London: Royal College of Physicians, 2006.Google Scholar
5Rieder, H. Epidemiology of tuberculosis. In Gibson, G, Geddes, D, Costabel, U, Sterk, P, Corrin, B (eds). Respiratory Medicine. Saunders, 2003, pp. 938–943.Google Scholar
6Mori, T, Harada, N, Higuchi, K, Sekiya, Y, Uchimara, K, Shimao, T. Waning of the specific interferon-gamma response after years of tuberculosis infection. Int J Tuberculosis Lung Dis 2007; 11: 1021–25.Google ScholarPubMed
7Bennett, D, Courval, J, Onorato, I, Agerton, T, Gibson, J, Lambert, L et al. Prevalence of tuberculosis infection in the United States population: the national health and nutrition examination survey 1999–2000. Am J Resp Crit Care Med 2008; 177: 348–55.CrossRefGoogle ScholarPubMed
8Kobashi, Y, Mouri, K, Yugi, S, Obase, Y, Miyashita, N, Okimoto, N et al. Clinical utility of the QuantiFERON TB-2G test for elderly patients with active tuberculosis. Chest 2008; 133: 1196–1202.CrossRefGoogle ScholarPubMed
9Stead, W. Tuberculosis among elderly persons, as observed among nursing home residents. Int J Tuberculosis Lung Dis 1998; 2: 564–70.Google ScholarPubMed
10Geng, E, Krieswirth, B, Driver, C, Li, J, Burzynski, J, Dellalatta, P et al. Changes in the transmission of tuberculosis in New York City from 1990 to 1999. New Engl J Med 2002; 346: 1453–58.CrossRefGoogle ScholarPubMed
11Yang, Z, de Haas, P, Wachmann, C, van Soolingen, D, van Embden, J, Andersen, A. Molecular epidemiology of tuberculosis in Denmark in 1992. J Clin Microbiol 1995; 33: 2077–81.CrossRefGoogle ScholarPubMed
12France, A, Cave, M, Bates, J, Foxman, B, Chu, T, Yang, Z. What's driving the decline in tuberculosis in Arkansas? A molecular epidemiologic analysis of tuberculosis trends in a rural, low-incidence population, 1997–2003. Am J Epidemiol 2007; 166: 662–71.CrossRefGoogle Scholar
13CDC. Reported tuberculosis in the United States, 2008. Atlanta, GA. US Department of Health and Human Services, 2009.Google Scholar
14Rose, A, Watson, J, Graham, C, Nunn, A, Drobniewski, F, Ormerod, L et al. Tuberculosis at the end of the 20th century in England and Wales: results of a national survey in 1998. Thorax 2001; 56: 173–79.CrossRefGoogle ScholarPubMed
15Bates, M, Khalakdina, A. Risk of tuberculosis from exposure to tobacco smoke. Arch Intern Med 2007; 167: 335–42.CrossRefGoogle ScholarPubMed
16Aissa, K, Madhi, F, Ronsin, N, Delerocque, F, Lecuyer, A, Decludt, B et al. Evaluation of a model for efficient screening of tuberculosis contact subjects. Am J Resp Crit Care Med 2008; 177: 1041–47.CrossRefGoogle Scholar
17Ponce-de-Leon, A, Garcia-Garcia, M, Garcia-Sancho, M, Gomez-Perez, F, Valdespino-Gomez, J, Oliaz-Fernandez, G et al. Tuberculosis and diabetes in southern Mexico. Diabetes Care 2004; 27: 1584–90.CrossRefGoogle ScholarPubMed
18Leung, C, Lam, T, Chan, W, Yew, W, Ho, K, Leung, G et al. Diabetic control and risk of tuberculosis: a cohort study. Am J Epidemiol 2008; 167: 1486–94.CrossRefGoogle ScholarPubMed
19Khan, A, Sterling, T, Reves, R, Vernon, A, Horsburgh, R. Lack of weight gain and relapse risk in a large tuberculosis treatment trial. Am J Resp Crit Care Med 2006; 174: 344–48.CrossRefGoogle Scholar
20Global tuberculosis control: surveillance, planning, financing. Geneva: World Health Organisation, 2007.Google Scholar
21Ahmed, A, Abubakar, I, Delpech, V, Lipman, M, Boccia, D, Forde, J et al. The growing impact of HIV infection on the epidemiology of tuberculosis in England and Wales: 1999–2003. Thorax 2007; 62: 672–76.CrossRefGoogle Scholar
22Albalak, R, O'Brien, R, Kammerer, S, O'Brien, S, Marks, S, Castro, K et al. Trends in tuberculosis/human immunodeficiency virus comorbidity, United States, 1993–2004. Archives Intern Med 2007; 167: 2443–52.CrossRefGoogle ScholarPubMed
23Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2007: US Department of Health and Social Services Centers for Disease Control and Prevention, 2009: vol 19.Google Scholar
24Pozniak, A, Miller, R, Lipman, M, Freedman, A, Ormerod, L, Johnson, M et al. BHIVA treatment guidelines for tuberculosis (TB)/HIV infection 2005. HIV Medicine 2005; 6 (suppl 2): 62–83.CrossRefGoogle ScholarPubMed
25Dixon, W, Hyrich, K, Warson, K, Silman, A, Symmons, D. Serious infection rates in patients receiving biologic therapy in the United Kingdom: results from the BSR biologics register (BSRBR). BSR Biologics Register Newsletter 2006; March 2006: 9–10.Google Scholar
26Keane, J, Gershon, S, Wise, R, Mirabile-Levens, E, Kasznica, J, Schweiterman, W et al. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. New Engl J Med 2001; 345: 1098–104.CrossRefGoogle ScholarPubMed
27Tubach, F, Salmon, D, Ravaud, P, Allanore, Y, Goupille, P, Breban, M et al. Risk of tuberculosis is higher with anti-tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy. Arthritis Rheum 2009; 60: 1884–94.CrossRefGoogle ScholarPubMed
28British Thoracic Society Standards of Care Committee. BTS recommendations for assessing risk and for managing Mycobacterium tuberculosis infection and disease in patients due to start anti-TNFα treatment. Thorax 2005; 60: 800–5.CrossRefGoogle Scholar
29Hutton, MD, Cauthen, GM, Bloch, AB. Results of a 29-state survey of tuberculosis in nursing homes and correctional facilities. Public Health Reports 1993; 108: 305–314.Google ScholarPubMed
30Nisar, M, Williams, C, Ashby, D, Davies, P. Tuberculin testing in residential homes for the elderly. Thorax 1993; 48: 1257–60.CrossRefGoogle ScholarPubMed
31Stead, W. Tuberculosis among elderly persons: an outbreak in a nursing home. Annals Intern Med 1981; 94: 606–10.CrossRefGoogle ScholarPubMed
32Office for National Statistics, UK, 2001. www.statistics.gov.ukGoogle Scholar
33Prevention and control of tuberculosis in facilities providing long term care to the elderly. Recommendations of the advisory committee for elimination of tuberculosis. MMWR Weekly Rep 1990; 39 (RR-10): 7–20.Google Scholar
34Khan, K, Wang, J, Marras, T. Non-tuberculous mycobacterial sensitization in the United States: national trends over three decades. Am J Resp Crit Care Med 2007; 176: 306–13.CrossRefGoogle Scholar
35Perez-Guzman, C, Vargas, M, Torres-Cruz, A, Villareal-Velarde, H. Does aging modify pulmonary tuberculosis? Chest 1999; 116: 961–67.CrossRefGoogle ScholarPubMed
36Rocha, M, Pereira, S, Barros, H, Seabra, J. Does pulmonary tuberculosis change with ageing? Int J Tuberculosis Lung Dis 1997; 1: 147–51.Google ScholarPubMed
37Perez-Guzman, C, Torres-Cruz, A, Villareal-Velarde, H, Vargas, M. Progressive age-related changes in pulmonary tuberculosis images and the effect of diabetes. Am J Resp Crit Care Med 2000; 162: 1738–40.CrossRefGoogle ScholarPubMed
38Geng, E, Kreiswirth, B, Burzynski, J, Schluger, N. Clinical and radiographic correlates of primary and reactivation tuberculosis. A molecular epidemiological study. JAMA 2005; 293: 2740–45.CrossRefGoogle Scholar
39Greenaway, C, Menzies, D, Fanning, A, Grewal, R, Yuan, L, Fitzgerald, J. Delay in diagnosis among hospitalized patients with active tuberculosis – predictors and outcomes. Am J Resp Crit Care Med 2002; 165: 927–33.CrossRefGoogle ScholarPubMed
40Wallace, R, Kammerer, S, Iademarco, M, Althomsons, S, Winston, C, Navin, T. Increasing proportions of advanced pulmonary tuberculosis reported in the United States: are delays in diagnosis on the rise? Am J Resp Crit Care Med 2009; 180: 1016–22.CrossRefGoogle ScholarPubMed
41McNicol MW. Clinical features and management. In Brewis, R, Gibson, G, Geddes, D (eds). Respiratory Medicine. 1st edn.London: Balliere Tindall, 1990.Google Scholar
42Brown, M, Varia, H, Bassett, P, Davidson, R, Wall, R, Pasvel, G. Prospective study of sputum induction, gastric washing, and bronchoalveolar lavage for the diagnosis of pulmonary tuberculosis in patients who are unable to expectorate. Clin Infect Dis 2007; 44: 1415–20.CrossRefGoogle ScholarPubMed
43Saglam, L, Akgun, M, Aktas, E. Usefulness of induced sputum and fibre-optic bronchoscopy specimens in the first diagnosis of pulmonary tuberculosis. J Int Med Res 2005; 33: 260–65.CrossRefGoogle Scholar
44Al Zahrani, K, Al Jahdali, H, Poirier, L, Rene, P, Gennaro, M, Menzies, D. Accuracy and utility of commercially available amplification and serologic tests for the diagnosis of minimal pulmonary tuberculosis. Am J Resp Crit Care Med 2000; 162: 1323–29.CrossRefGoogle ScholarPubMed
45Noordhoek, G, Kolk, A, Bjune, G, Catty, D, Dale, J, Fine, P et al. Sensitivity and specificity of PCR for detection of Mycobacterium tuberculosis: a blind comparison study among seven laboratories. J Clin Microbiol 1994; 32: 277–84.CrossRefGoogle ScholarPubMed
46Barnard, M, Albert, H, Coetzee, G, O'Brien, R, Bosman, M. Rapid molecular screening for multidrug resistant tuberculosis in a high volume public health laboratory in South Africa. Am J Resp Crit Care Med 2008; 177: 787–92.CrossRefGoogle Scholar
47Ling, D, Zwerling, A, Pai, M. Genotype MTBDR assays for the diagnosis of multidrug-resistant tuberculosis: a meta-analysis. Eur Resp J 2008; 32: 1165–74.CrossRefGoogle ScholarPubMed
48The Mantoux test. Administration, reading and interpretation. NHS: Department of Health Publications. Available at: http://www.immunisation.nhs.uk/Files/mantouxtest.pdf (accessed 18 March).Google Scholar
49Mancusco, J, Tobler, S, Keep, L. Pseudoepidemics of tuberculin skin test conversions in the US army after recent deployments. Am J Resp Crit Care Med 2008; 177: 1285–89.CrossRefGoogle Scholar
50Chan-Yeung, M, Cheung, A, Dai, D. Prevalence and determinants of positive tuberculin reactions in residents of old age homes in Hong Kong. Int J Tuberculosis Lung Dis 2006; 10: 892–98.Google ScholarPubMed
51Van Den Brande, P, Demedts, M. Four-stage tuberculin testing in elderly subjects induces age-dependent progressive boosting. Chest 1992; 101: 447–50.CrossRefGoogle ScholarPubMed
52Mori, T, Sakatani, M, Yamagishi, F, Takashima, T, Kawabe, Y, Nagao, K et al. Specific detection of tuberculosis infection: an interferon gamma-based assay using new antigens. Am J Resp Crit Care Med 2004; 170: 59–64.CrossRefGoogle ScholarPubMed
53Kobashi, Y, Sugin, T, Shimuza, H, Ohue, Y, Mouri, K, Obase, Y et al. Clinical evaluation of the T.spot.TB test for patients with indeterminate results on the QuantiFERON TB-2G test. Intern Med 2009; 48: 137–42.CrossRefGoogle ScholarPubMed
54Menzies, D, Madhukar, P, Comstock, G. Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Annals Intern Med 2007; 146: 340–54.CrossRefGoogle ScholarPubMed
55Kobashi, Y, Obase, Y, Fukuda, M, Yoshida, K, Miyashita, N, Oka, M. Clinical re-evaluation of the Quantiferon TB-2G test as a diagnostic method for differentiating active tuberculosis from non-tuberculous mycobacteriosis. Clin Infect Dis 2006; 43: 1540–46.CrossRefGoogle Scholar
56Dosanjh, D, Hinks, T, Innes, J, Deeks, J, Pasvol, G, Hackforth, S et al. Improved diagnostic evaluation of suspected tuberculosis. Annals Intern Med 2008; 148: 325–36.CrossRefGoogle ScholarPubMed
57Arend, S, Thijsen, S, Leyten, E, Bouwman, J, Franken, W, Koster, B et al. Comparison of two interferon-γ assays and tuberculin skin test for tracing tuberculosis contacts. Am J Resp Crit Care Med 2007; 175: 618–27.CrossRefGoogle ScholarPubMed
58Mazurek, G, LaBue, P, Daley, C. Comparison of a whole blood interferon-gamma assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. JAMA 2001; 286: 1740–47.CrossRefGoogle ScholarPubMed
59Diel, R, Loddenkemper, R, Meywald-Walter, K, Niemann, S, Nienhaus, A. Predictive value of a whole blood IFN-γ assay for the development of active tuberculosis disease after recent infection with Mycobacterium tuberculosis. Am J Resp Crit Care Med 2008; 177: 1164–70.CrossRefGoogle ScholarPubMed
60Aiken, A, Hill, P, Fox, A, McAdam, K, Jackson-Sillah, D, Lugos, M et al. Reversion of the ELISPOT test after treatment in Gambian tuberculosis cases. BMC Infect Dis 2006; 6: 66.CrossRefGoogle ScholarPubMed
61Chee, C, KhinMar, K, Gan, S, Barkham, M, Pushparani, M, Wang, Y. Latent tuberculosis infection treatment and T-cell responses to Mycobacterium tuberculosis. Am J Resp Crit Care Med 2007; 175: 282–87.CrossRefGoogle ScholarPubMed
62Nahid, P, Pai, M, Hopewell, P. Advances in the diagnosis and treatment of tuberculosis. Proc Am Thoracic Soc 2006; 3: 103–10.CrossRefGoogle ScholarPubMed
63Rao, S, Mookerjee, A, Obasanjo, O, Chaisson, R. Errors in the treatment of tuberculosis in Baltimore. Chest 2000; 117: 734–37.CrossRefGoogle ScholarPubMed
64David, H. Probability distribution of drug-resistant mutants in unselected populations of Mycobacterium tuberculosis. Appl Microbiol 1970; 20: 810–14.CrossRefGoogle ScholarPubMed
65Billington, O, McHugh, T, Gillespie, S. Physiological cost of rifampin resistance induced in vitro in Mycobacterium tuberculosis. Antimicrob Agents Chemother 1999; 43: 1866–69.CrossRefGoogle ScholarPubMed
66Mahmoudi, A, Iseman, M. Pitfalls in the care of patients with tuberculosis: common errors and their association with the acquisition of drug resistance. JAMA 1993; 270: 65–68.CrossRefGoogle ScholarPubMed
67Yee, D, Valiquette, C, Pelletier, M, Parisien, I, Rocher, I, Menzies, D. Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis. Am J Resp Crit Care Med 2003; 167: 1472–77.CrossRefGoogle ScholarPubMed
68Schaberg, T, Rebhan, K, Lode, H. Risk factors for side-effects of isoniazid, rifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis. Eur Resp J 1995; 9: 2026–30.CrossRefGoogle Scholar
69Fernandez-Villar, A, Sopena, B, Fernandez-Villar, J, Vazquez-Gallardo, R, Ulloa, F, Leiro, V et al. The influence of risk factors on the severity of anti-tuberculosis drug-induced hepatotoxicity. Int J Tuberculosis Lung Dis 2004; 8: 1499–505.Google ScholarPubMed
70Chang, K, Leung, C, Yew, W, Tam, C. Standard anti-tuberculous treatment and hepatotoxicity: do dosing schedules matter? Eur Resp J 2007; 29: 347–51.CrossRefGoogle Scholar
71Saukkonen, J, Cohn, D, Jasmer, R, Schenker, S, Jereb, J, Nolan, C et al. An official ATS statement: hepatotoxicity of antituberculous therapy. Am J Resp Crit Care Med 2006; 174: 935–52.CrossRefGoogle Scholar
72Farah, F, Taylor, W, Rawlins, M, James, O. Hepatic drug acetylation and oxidation: effects of aging in man. Br Med J 1977; 2: 155–56.CrossRefGoogle ScholarPubMed
73McIlleron, H, Hackforth, S, Wash, P, Burger, A, Norman, J, Folb, P et al. Determinants of rifampin, isoniazid, pyrazinamide, and ethambutol pharmacokinetics in a cohort of tuberculosis patients. Antimicrob Agents Chemother 2006; 50: 1170–77.CrossRefGoogle Scholar
74Low, S, Ang, L, Cutter, J, James, L, Chee, C, Wang, Y et al. Mortality among tuberculosis patients on treatment in Singapore. Int J Tuberculosis Lung Dis 2009; 13: 328–34.Google ScholarPubMed
75Rao, V, Iademarco, E, Fraser, V, Kollef, M. The impact of comorbidity on mortality following in-hospital diagnosis of tuberculosis. Chest 1998; 114: 1244–52.CrossRefGoogle ScholarPubMed
76Pablos Mendez, A, Sterling, T, Frieden, T. The relationship between delayed or incomplete treatment and all-cause mortality in patients with tuberculosis. JAMA 1996; 276: 1223–28.CrossRefGoogle ScholarPubMed
77Dooley, K, Tang, T, Golub, J, Dorman, S, Cronin, W. Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis. Am J Trop Med Hygiene 2009; 80: 634–39.CrossRefGoogle ScholarPubMed
78Falk, A, Fuchs, G. Prophylaxis with isoniazid in inactive tuberculosis. Chest 1978; 73: 44–48.CrossRefGoogle ScholarPubMed
79Egsmose, T, Ang'awa, J, Pott, S. The use of isoniazid among household contacts of open cases of pulmonary tuberculosis. Bulletin World Health Org 1965; 33: 419–33.Google ScholarPubMed
80Girling, D, Chan, S. A double-blind placebo-controlled clinical trial of three antituberculosis chemoprophylaxis regimens in patients with silicosis in Hong Kong. Am Rev Resp Dis 1992; 145: 36–41.Google Scholar
81Lee, A, Mennone, J, Jones, R, Paul, W. Risk factors for hepatotoxicity associated with rifampin and pyrazinamide for the treatment of latent tuberculosis infection: experience from three public health tuberculosis clinics. Int J Tuberculosis Lung Dis 2002; 6: 995–1000.Google ScholarPubMed
82Aziz, H, Shubair, M, DeBari, V, Ismail, M, Khan, M. Assessment of age-related isoniazid hepatotoxicity during treatment of latent tuberculosis infection. Curr Med Res Opin 2006; 22: 217–21.CrossRefGoogle ScholarPubMed
83Sorresso, D, Mehta, J, Harvill, L, Bentley, S. Underutilization of isoniazid chemoprophylaxis in tuberculosis contacts 50 years of age and older. Chest 1995; 108: 706–11.CrossRefGoogle ScholarPubMed
84Shieh, F, Snyder, G, Horsburgh, R, Bernardo, J, Murphy, C, Saukkonen, J. Predicting non-completion of treatment for latent tuberculosis infection. Am J Resp Crit Care Med 2006; 174: 717–21.CrossRefGoogle Scholar
85Balcells, M, Thomas, S, Godfrey-Faussett, P, Grant, A. Isoniazid preventive therapy and risk for resistant tuberculosis. Emerging Infect Dis 2006; 12: 744–51.CrossRefGoogle ScholarPubMed
86American Thoracic-Society. Targeted tuberculin skin testing and treatment of latent tuberculosis infection. Am J Resp Crit Care Med 2000; 161: S221–47.Google Scholar
87Zevallos, M, Justman, J. Tuberculosis in the elderly. Clinics Geriatr Med 2003; 19: 121–38.CrossRefGoogle ScholarPubMed
88Thrupp, L, Bradley, S, Smith, P, Simor, A, Gantz, N, Crossley, K et al. Tuberculosis prevention and control in long-term-care facilities for older adults. Infection Control Hosp Epidemiol 2004; 25: 1097–108.CrossRefGoogle ScholarPubMed
89Trial of BCG vaccines in south India for tuberculosis prevention: first report. Bulletin World Health Org 1979; 57: 819–27.Google Scholar
90Sterne, J, Rodrigues, L, Guedes, I. Does the efficacy of BCG decline with time since vaccination? Int J Tuberculosis Lung Dis 1998; 2: 200–7.Google ScholarPubMed
91Leung, C, Tam, C, Chan, S, Chan-Yeung, M, Chan, C, Chang, K. Efficacy of the BCG revaccination programme in a cohort given BCG vaccination at birth in Hong Kong. Int J Tuberculosis Lung Dis 2001; 5: 717–23.Google Scholar
92Jindani, A, Dore, C, Mitchison, D. Bactericidal and sterilizing activities of antituberculosis drugs during the first 14 days. Am J Resp Crit Care Med 2003; 167: 1348–54.CrossRefGoogle ScholarPubMed
93Bailey, W, Gerald, L, Kimerling, M, Redden, D, Brook, N, Bruce, F et al. Predictive model to identify positive tuberculosis skin test results during contact investigations. JAMA 2002; 287: 996–1002.CrossRefGoogle ScholarPubMed
94Reichler, M, Reves, R, Bur, S, Thompson, V, Mangura, B, Ford, J et al. Evaluation of investigations conducted to detect and prevent transmission of tuberculosis. JAMA 2002; 287: 991–95.CrossRefGoogle ScholarPubMed
95Meredith, S, Watson, J, Citron, K, Cockcroft, A, Darbyshire, J. Are healthcare workers in England and Wales at increased risk of tuberculosis? Br Med J 1996; 313: 522–25.CrossRefGoogle ScholarPubMed
96Kline, S, Hedemark, L, Davies, S. Outbreak of tuberculosis among regular patrons of a neighborhood bar. New Engl J Med 1995; 333: 222–27.CrossRefGoogle ScholarPubMed
97A strategic plan for the elimination of tuberculosis in the United States. MMWR Suppl 1989; 38 (S–3): 1–25.Google Scholar