To the Editor.
—In their article on the extent of drug-resistant tuberculosis (TB) in the United States, Dr Bloch and colleagues1 recount the particular impact of the current epidemics on New York City (NYC) and note difficulties faced by TB patients in NYC in adhering to anti-TB treatment regimens.In 1992 the New York State Department of Health successfully engaged a coalition of public and private community providers to make directly observed therapy (DOT) services for individuals with TB widely available throughout NYC.2 Directly observed therapy is offered at various locations, including hospital clinics, neighborhood health centers, shelters, soup kitchens, and substance abuse treatment programs. Extensive use of outreach to place DOT in the community convenient to individual patients being served is another primary strategy. Incentives and enablers are used to promote compliance and minimize access barriers. An assortment of tactics assure availability of anti-TB medications. This program
Klein SJ, DiFerdinando GT, Naizby BE. Directly Observed Therapy for Tuberculosis in New York City. JAMA. 1994;272(6):435-436. doi:10.1001/jama.1994.03520060033025