 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Kimberly M. Taylor, MPH, General Internal Medicine, University of Alabama Birmingham, 443 Ryals Building, 1665 University Boulevard, Birmingham, AL 35294, 205-975-5748, kmtaylor@uab.edu, Joan Mangan, PhD, MST, Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd., Ryals Building, Suite 217, Birmingham, AL 35294-0022, Marilyn Crain, MD, Pediatrics, University of Alabama Birmingham, Children's Harbor Center, 1600 Seventh Avenue South, Birmingham, AL 35233, Nancy B. Keenon, MPH, Tuberculosis Control, Alabama Department of Public Health, The RSA Tower, Suite 1450, 201 Monroe Street, Montgomery, AL 36130-3017, V. Jim Alosi, BS, Tuberculosis Control, Jefferson County Department of Health, 1400 Sixth Avenue South, Birmingham, AL 35202, A. Edward Khan, MD, Pulmonary Division, University of Alabama Birmingham, 443 Ryals Building, 1665 University Boulevard, Birmingham, AL 35294, and Michael E. Kimerling, MD, MPH, Department of Medicine and Epidemiology, University of Alabama Birmingham, 443 Ryals Building, 1665 University Boulevard, Birmingham, AL 35294.
Background: In 2002, a large Alabama city reported an outbreak of Multi-Drug Resistant Tuberculosis (MDR-TB) in one adult and five children less than 5 years of age, all within the same extended family yet in two geographic areas. To meet the challenges of this episode a variety of agencies and departments combined resources to form a broad-based health management team. Methods: Mixed qualitative research included observation, in-depth interviews, fieldnotes, focus groups and traditional epidemiologic contact investigation. Discussion: Alabama historically has a high incidence of TB, which predominantly includes minority and non-white populations. Case rates have declined in previous years and now approach the national average, with 5.9 cases per 100,000 in 2001. However, MDR-TB cases have accounted for less than 1% of the cases. Pediatric (£ 15 years) cases comprised only 3.5% of the total cases in 2001. No incident of pediatric MDR-TB had ever been reported in the state. The youngest child, a four-month-old with culture confirmed MDR-TB, is among the youngest reported nationally. A rapid plan of action was necessary to ensure continuum of care for this unique population. In addition to medical complexities, obstacles associated with minority patients with a lower socio-economic status had to be overcome. Results: Development of a multi-disciplinary response team to tackle complex medical, social, and financial issues; an extensive contact investigation; and administrative duties. This comprehensive team included local, state, and national health officials, a pediatric hospital, home-health agency, physicians, surgeons, pharmacies, nutritionists and social workers as well as multiple governmental entities.
Learning Objectives:
Keywords: TB, Outbreaks
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.