Email updates

Keep up to date with the latest news and content from BMC Medicine and BioMed Central.

Journal App

google play app store
Open Access Open Badges Commentary

Control of tuberculosis in large cities in developed countries: an organizational problem

Joan A Caylà* and Angels Orcau

Author affiliations

Epidemiology Service, Public Health Agency of Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain

For all author emails, please log on.

Citation and License

BMC Medicine 2011, 9:127  doi:10.1186/1741-7015-9-127

Published: 28 November 2011


Tuberculosis (TB) is still a serious public health issue, even in large cities in developed countries. Control of this old disease is based on complicated programs that require completion of long treatments and contact tracing. In an accompanying research article published in BMC Public Health, Bothamley and colleagues found that areas with a ratio lower than one nurse per forty notifications had increased rates with respect to TB notifications, smear-positive cases, loss to follow-up and treatment abandonment across the UK. Furthermore, in these areas there was less opportunity for directly observed therapy, assistance with complex needs, educational outreach and new-entrant screening. In this commentary, we discuss the importance of improving organizational aspects and evaluating TB control programs. According to Bothamley and colleagues, a ratio of one nurse per forty notifications is an effective method of reducing the high TB incidences observed in London and in other cities in developed countries, or to maintain the decline in incidence in cities with lower incidences. It is crucial to evaluate TB programs every year to detect gaps early.

See related article: webcite