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July 20, 1994

Tracking Tuberculosis-Reply

Author Affiliations

East Elmhurst, NY

JAMA. 1994;272(3):201. doi:10.1001/jama.1994.03520030040017

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In Reply.  —Dr Bloch and colleagues state that compliance with therapy "must be the highest priority of all state and local TB programs," but fail to endorse the explicit standard recommended by my Editorial—the prevalence registry standard. The prevalence registry standard requires every state to identify a supervisor for every active TB patient and track each patient's compliance with therapy. Accountability is thereby assured. State TB control programs would be evaluated by random checks of registry accuracy with interviews of patients and treating physicians.Why has the prevalence registry standard not been adopted? Bloch and colleagues inform us that the CDC surveillance efforts were supported almost entirely by state and local funding. The CDC lived at the largesse of local authorities who I suspect would have been less than pleased to have been advised that their control efforts were grossly inadequate and their documentation of accountability pathetic.For those of

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