2009
DOI: 10.1001/archinternmed.2008.535
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Tuberculosis and Substance Abuse in the United States, 1997-2006

Abstract: Substance abuse is the most commonly reported behavioral risk factor among patients with TB in the United States. Patients who abuse substances are more contagious (eg, smear positive) and remain contagious longer because treatment failure presumably extends periods of infectiousness. Increased transmission is consistent with our finding that patients who abuse substances were more likely to be involved in a localized genotype cluster, which can represent recent transmission.

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Cited by 92 publications
(62 citation statements)
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References 47 publications
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“…Recent reports indicate a lower prevalence of LTBI, lower rate of progression to active TB, and higher proportion of discontinuation of therapy for LTBI than previously assumed (15)(16)(17)(18)(19)(20). Further, the Centers for Disease Control and Prevention (CDC) recently released updated guidelines for using IGRA to screen for Mycobacterium tuberculosis infection, recommending both TST and IGRA in groups at higher risk for developing active TB (4).…”
Section: Reactivation Of Latent Tuberculosis Infection (Ltbi) Accountsmentioning
confidence: 91%
“…Recent reports indicate a lower prevalence of LTBI, lower rate of progression to active TB, and higher proportion of discontinuation of therapy for LTBI than previously assumed (15)(16)(17)(18)(19)(20). Further, the Centers for Disease Control and Prevention (CDC) recently released updated guidelines for using IGRA to screen for Mycobacterium tuberculosis infection, recommending both TST and IGRA in groups at higher risk for developing active TB (4).…”
Section: Reactivation Of Latent Tuberculosis Infection (Ltbi) Accountsmentioning
confidence: 91%
“…12,13 Similarly, lack of access to routine care may also explain the increased likelihood of secondary cases following the diagnosis of TB among minorities, 14 as the longer a TB case remains undiagnosed, the greater the chances of continued transmission. It is also possible that some cases of TB among those without routine access to care were never diagnosed and reported.…”
Section: Public Health Action Predicting Future Related Tb Cases 50mentioning
confidence: 99%
“…For instance, patient support groups are seen as an important factor for successful treatment outcomes, as the mental-health issues surrounding MDR-TB have received good attention [43]. Some MDR-TB programmes have developed strong links with substance dependency interventions while recognising that there is a limited arsenal of TB drugs to combat the disease, and substance abuse can hinder adherence and drug absorption [142]. The guidelines for treating comorbidities for MDR-TB patients are more developed than for drug-susceptible TB patients, due to the importance of drug interactions in various comorbidities and the effect on treatment outcomes these possess [143,144].…”
Section: Implications For Tb Control Programmesmentioning
confidence: 99%