Washington, D.C., Officials, Health Workers Criticize City’s TB Surveillance, Care, Especially Among HIV-Positive People
Washington, D.C., city officials and health workers have questioned the ability of the city Health Department's Tuberculosis Control Bureau to properly treat and prevent the transmission of tuberculosis, the Washington Post reports. Staff members have reported supply shortages, and city officials say that the bureau's facilities have unreliable heating, water and air-conditioning systems. In addition, the agency has stopped filing regular TB reports with CDC, making it impossible to track the spread of the disease. Abdi Naficy, a doctor from the National Institute of Allergy and Infectious Diseases, said that the bureau makes serious medical errors, especially with patients who have multidrug-resistant TB and are HIV-positive, a combination of conditions that is very difficult to treat. "Physicians at the Bureau of TB Control have decided of their own accord and without consultation with the patient's primary physician to make medical diagnoses and prescribe therapy," Naficy wrote in an e-mail to the bureau last year, adding, "At times this action could be best described as malpractice." Peter Hotez, chair of microbiology and tropical medicine at George Washington University, said that New York City in the late 1980s was "practically brought to its knees" because of similar lapses, adding, "If it is really true that the District has become complacent with this therapy, especially among HIV-infected patients with TB, then they are potentially creating a timebomb" (Goldstein, Washington Post, 7/19).
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