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A systematic comparison of tuberculosis (TB) cases and rates between the USA and E&W (England and Wales), shows diametrically opposed trends. Between 1993 and 2010 in the USA, active TB cases fell from 25 107 to 11 182,1 a fall of 55%. By contrast in E&W, notified TB cases rose from 5104 in 19932 ,3 to 7901 in 2010,4 an increase of 55%.
Case management is not the explanation for the difference, as both countries use rifampicin and isoniazid based 6-month short course chemotherapy, with high completion rates, 92.7% for the USA1 and 83.6% of survivors in E&W.4 Equally, different BCG policies do not account for the difference as the USA has never used BCG as a health control measure.
Both countries now have a majority of TB cases in foreign-born …
Footnotes
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Correction notice This article has been corrected since it was published Online First. The author name Parikh has been amended to read Pareek in the text and the references.
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Competing interests None.
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Provenance and peer review Commissioned; internally peer reviewed.