Increase in incidence of tuberculosis

BMJ 1995;311:122 (8 July)

Letters

Increase in incidence of tuberculosis

EDITOR,--As Janet Darbyshire points out, the recent increasein notifications of tuberculosis may partly be due to a fallin undernotification.¹ However, the incidence of this conditionprobably has increased, particularly in areas of social deprivation.²At St George's Hospital, which serves a large area of southLondon, notifications have risen from 44 in 1988 to 118 in 1994.

In the United States, particularly in New York, where the incidenceof both tuberculosis and infection with resistant organismshas risen, poor compliance has been a major contributory factor.³The introduction of supervised chemotherapy has led to a considerableimprovement.⁴ Supervision of treatment in Britain is often lackadaisical,and we could learn from the American experience. In a reviewof the situation in New York Bellin suggested that, in additionto the disease being notified, the satisfactory completion oftreatment should be reported to a national authority.⁵ Doctorswith a high . . . [Full text of this article]