|| DukeMedNews || Improving Education for Tuberculosis DIagnosis

This week on Duke MedMinute: Duke University Medical Center tuberculosis specialist Dr. Carol Dukes Hamilton, who has received a Tuberculosis Academic Award from the National Heart, Lung, and Blood Institute, talks about developing strategies to improve education for health care workers in the diagnosis and treatment of TB.

Background: The five-year, $375,000 award by the National Institutes of Health agency is intended to help stem the rising incidence of tuberculosis in the United States. Three such awards have been granted each year for the past four years; the Duke award is one of few dealing with TB in rural settings.

Less than 10 years ago, scientists were predicting the imminent eradication of tuberculosis in the United States. Now, due mainly to the rise of TB in people living with HIV and the increase in immigration from Southeast Asia and Africa, TB once again poses a serious threat to U.S. public health. North Carolina, whose incidence rate ranks in the middle of the 50 states, has a number of counties — concentrated in the eastern portion of the state — with TB incidence rates rivaling the nation’s largest cities. The declining incidence of TB nationwide during the late 1980s and early 1990s was accompanied by a decrease in federal spending on TB research and dwindling attention on the disease from the medical community.

Suggested lead: Less than 10 years ago, scientists were predicting the elimination of tuberculosis in the United States. But now, TB one again poses a serious threat to public health. TB is on the rise in many rural areas, and researchers at Duke are working to reverse that trend. Melinda Stubbee explains.

SOQ…:60 (Preview this in a AIFF or WAV file in 8 bit mono. For the full interview in high quality ISDN sound, call the newsline.)

In Cut 1, Hamilton says they’re now finding that many health care providers are not adequately equipped to diagnose and manage patients with TB, and the situation is especially true in rural areas, where many providers have had minimal experience with TB.

Cut 1…care of patients…:18 (Preview this in a AIFF or WAV file in 8 bit mono. For the full interview in high quality ISDN sound, call the newsline.)

What makes the rise in TB so frustrating for physicians, Hamilton says, is that it is usually completely curable with drugs. However, the drugs must be taken every day for at least six to 12 months to eradicate the disease, but many patients, who can start feeling better within six weeks, stop taking the medications too soon.

Cut 2…with tuberculosis…:20