Tuberculosis (TB) remains a major global health concern, with an estimated 8.7 million new cases reported in 2011 (World Health Organization). TB is the second-leading cause of death from an infectious disease worldwide, resulting in 1.4 million deaths in 2011. In the United States, there were more than 10,000 new TB cases reported in 2011.
Historically, TB had declined as a public health threat as a consequence of improved social and economic conditions, as well as the development of effective therapy in the 1950s. However, there was an unexpected resurgence of TB in the mid-1980s and early 1990s, which was due in part to deterioration of TB prevention and control programs. While reduced focus on and funding for TB control caused part of the TB resurgence in the United States, additional factors reinforced this increase:
- Onset of the human immunodeficiency virus (HIV) epidemic
- Increased globalization
- Subsequent increases in TB cases among foreign-born persons
- Suboptimal management of TB cases
- Emergence of drug-resistant TB
The resurgence of the disease prompts a renewed focus on improving TB prevention and control, including targeted intervention among high-risk groups, rapid identification of persons with TB, initiation of appropriate treatment, and adoption of strategies to ensure adherence and completion of treatment.
The challenges of controlling tuberculosis remain and will continue to require complex public health interventions. The Mayo Clinic Center for Tuberculosis provides the necessary coordination and integration of services and education to meet these challenges.