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LESSONS FROM HISTORY OF SOCIOECONOMIC IMPROVEMENTS: A NEW APPROACH TO TREATING MULTI-DRUG-RESISTANT TUBERCULOSIS

Published online by Cambridge University Press:  08 October 2013

K. L. HOLLOWAY ,
K. STAUB ,
F. RÜHLI  and
M. HENNEBERG
K. L. HOLLOWAY*
Affiliation:
Biological Anthropology and Comparative Anatomy Research Unit, University of Adelaide, Australia
K. STAUB
Affiliation:
Centre for Evolutionary Medicine, Institute of Anatomy, Zürich, Switzerland
F. RÜHLI
Affiliation:
Centre for Evolutionary Medicine, Institute of Anatomy, Zürich, Switzerland
M. HENNEBERG
Affiliation:
Biological Anthropology and Comparative Anatomy Research Unit, University of Adelaide, Australia
*
1Corresponding author. Email: khollo@barwonhealth.org.au
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Summary

This study investigated the trends in tuberculosis mortality through time in Switzerland. Information on the decline in mortality before chemotherapies were introduced may be useful in developing countries where drug-resistant tuberculosis is now becoming a major problem. Swiss data were collected from historical records and comparative data were obtained from the literature for England and Wales, New York, Japan, Brazil and Sierra Leone. Logistic curves were fitted to examine the rate of decline before introduction of pharmacotherapies and these show that the decline would have continued without the introduction of chemical therapies, including antibiotics. In Switzerland, England and Wales and New York, the decline had occurred long before the introduction of specific anti-tuberculosis agents. In Brazil and Japan, chemical therapy was co-incident with the decline in tuberculosis mortality rates. Overall, it is suggested that the effective control of tuberculosis can be achieved through a combination of chemical interventions, conservative therapy (rest, good nutrition, ventilation, etc.) as well as public health interventions addressing hygiene, nutrition, reducing exposure to infections and educating the population about tuberculosis.

Type
Articles
Information
Journal of Biosocial Science , Volume 46 , Issue 5 , September 2014 , pp. 600 - 620
Copyright
Copyright © Cambridge University Press 2013 

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