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Alabama pays town’s residents to undergo TB testing

BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i706 (Published 05 February 2016) Cite this as: BMJ 2016;352:i706
  1. Owen Dyer
  1. 1Montreal

The US state of Alabama, struggling to gain control of a tuberculosis epidemic around the small town of Marion, has discovered more than 100 infections after offering money to citizens to undergo testing and treatment.

With a population of under 4000, the town’s active tuberculosis case rate has been around 100 times the state and national average, at 253 per 100 000 population. But efforts by the state’s public health department to trace potential contacts and persuade residents to get tested have met with suspicion and hostility.

“We had a very, very poor turnout,” Pam Barrett, director of the tuberculosis control division, told a local news outlet, AL.com.1 She said that, at one state sponsored health fair last year, “people threw beer bottles at us.”

The pervasive mistrust of government health workers among …

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