Results of 20 Years of Tuberculosis Control in Alaska

Johnson, Matt

doi:10.2307/4594777

Cited by 8 publications

(2 citation statements)

References 6 publications

(7 reference statements)

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“…In Des Prez's words (1979: 479), INH made 'tuberculosis... a medically curable illness in most cases'. Johnson (1973) has observed that decline in TB rate in Alaska was achieved despite few improvements in the socioeconomic-economic conditions of the Natives. Whereas in the years 1949 to 1951, 92% of the children aged seven to eight in the Yukon-Kuskokwim Delta were tuberculin-positive, by 1969-70 this number had declined to 2% (Kaplan and others 1972).…”

Section: Resultsmentioning

confidence: 99%

Tuberculosis in Western Alaska, 1900–1950

Flanders

1987

Polar Record

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Tuberculosis was the major cause of death among Alaska Native peoples during the first half of the twentieth century, with a crude death rate estimated at 810 per 100,000. Apart from a few medical articles, not much is known of the impact of the disease on the people. This paper reviews published articles, unpublished reports by government teachers, hospital records and other materials for several Native villages in western Alaska from the period 1900–50. These archival sources suggest that tuberculosis was prevalent at the start of the century, that tuberculosis morbidity and mortality increased until the public health efforts of the 1950s and '60s, and that highest mortality rates were found among women between the ages of 15 and 35. Traditional cultural practices that brought people together for fatiguing activities in confined areas may have contributed to the spread of the disease. Public health efforts of federal teachers aimed to improve personal hygiene, household cleanliness and ventilation. Their efforts were thwarted by environmental and economic factors, primarily the limited amount of wood. Ultimately, the comments of these public officials may have reflected more their own moral beliefs than the actual etiology of the disease.

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Section: Resultsmentioning

confidence: 99%

Tuberculosis in Western Alaska, 1900–1950

Flanders

1987

Polar Record

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“…Current regimens for preventive therapy are not without risk of adverse effects and their treatment duration of 3–9 months also pose challenges in patient acceptability and adherence. While mass screening and treatment programme for LTBI has helped to reduce the high TB risk in a small Alaskan community, better diagnostic and treatment tools than those currently available are required for the implementation of this TB control strategy on a population‐wide scale.…”

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confidence: 99%

Tuberculosis updates 2018: Innovations and developments to end TB

2017

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The 2013 tuberculosis (TB) review series 'Tuberculosis: Current state of knowledge' highlighted important gaps in our existing knowledge on the complex interactions between the pathogen and the host. We also detailed major limitations in current control strategies. 1 Since then, there have been major developments in new diagnostic tools and drugs/regimens for TB and latent TB infection (LTBI), some of which have modified clinical practice in both high-and low-burden countries. 2 In 2014, the World Health Assembly approved the 'End TB Strategy', which set ambitious targets to achieve a 95% reduction in TB death and 90% reduction in TB incidence rate by 2035. 3 To consolidate developments and to meet the upcoming challenges, we have invited a panel of international experts to critically re-examine the relevant issues in a new series of themed reviews focused on TB.Despite over two decades of effort to find and treat infectious sources, there were still an estimated 10.4 million incident TB cases with 1.7 million deaths in 2016. 2 The annual decline of TB incidence remained at around 2%, not much higher than the annual decline of TB mortality of 1.71% in the United Kingdom in the pre-chemotherapeutic era. 4 Resistance has also emerged to most of the medications used to treat TB, and the spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB is threatening TB control in many high-burden areas. 2 Against this background, there is a need to critically examine how we can turn the vision of the End TB Strategy into reality. Pursuing social protection, universal health coverage and optimizing the use of new tools from the development pipelines are necessary to achieve the priority targets of over 90% treatment coverage, treatment success rate and preventive treatment coverage, and accelerate the annual decline of TB incidence from 2% to 10% in the coming decade. With the current estimate that one quarter of the global population has been infected with the tubercle bacillus, 5 critical breakthroughs in either the screening and treatment of LTBI or the development of new TB vaccines are indispensable to further accelerate the annual decline of TB incidence to 17% beyond 2025.A high burden of LTBI is observed in rising elderly populations in many Asia-Pacific areas. This is largely as a result of the heightened transmission arising from the high TB incidence that peaked alongside rapid urbanization in the last century. 6 Older people often have a TB incidence several fold higher than younger people in these areas. 2,6 With frequent co-morbidities, TB in older people is often more difficult to diagnose and treat, posing a critical challenge in TB control. Wing Wai Yew et al. will discuss the epidemiological, clinical and mechanistic perspectives of TB in older people, highlighting the colliding epidemics of smoking, diabetes mellitus and TB, and how unravelling the underlying mechanisms might potentially help to prevent and better manage TB in this group.Vaccines are often regarded as a first-line tool ...

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Tuberculosis: Pathogenesis, Epidemiology and Prevention

Leitch¹

2000

Crofton and Douglas's Respiratory Diseases

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Results of 20 Years of Tuberculosis Control in Alaska

Cited by 8 publications

References 6 publications

Tuberculosis in Western Alaska, 1900–1950

Tuberculosis in Western Alaska, 1900–1950

Tuberculosis updates 2018: Innovations and developments to end TB

Tuberculosis: Pathogenesis, Epidemiology and Prevention

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