State gets $120,000 to reduce TB
The grant is to improve tuberculosis treatments in Hawaii, which leads the nation in cases
THE American Lung Association-Hawaii has given $120,000 to the state Tuberculosis Control Program to improve treatment and reduce the isle TB case rate.
TB rates have declined since 1992 but Hawaii continues to have the highest annual TB case rate in the nation, according to the Department of Health Web site.
The state had 116 tuberculosis cases last year -- an incident rate of 9.2 cases per 100,000 population, compared with 4.9 per 100,000 nationally.
About $110,000 of the Lung Association grant will be used to work with a private organization to train outreach workers for patients at high risk of developing TB, said Dr. Jessie Wing, chief of the Department of Health's TB Control Program.
The U.S. Centers for Disease Control, the American Thoracic Society and Infectious Disease Society of America recommend TB medications for at least six months for active cases and nine months for preventive therapy for patients with latent TB infections.
Directly Observed Therapy, in which trained personnel are present when medicines are taken, is considered critical to effective TB care.
But the tuberculosis program doesn't have the capacity to do the outreach work and few TB patients are receiving observed therapy, Wing said.
She said it's "a novel idea" to work with an outside agency to provide outreach workers.
The rest of the grant will pay for incentives such as pre-paid gasoline and food certificates for patients and high-risk residents to encourage completion of therapy.
Stopping and starting medications before completing therapy can lead to complications and drug resistant infections, according to the TB program.
One death from TB was reported here last year.
Nearly half of non U.S.-born clients screened in state TB clinics last year had latent TB infection. The largest number is from Asia and neighboring Pacific Islands.
Most cases occur among people who are 65 and older but four were under age 18, one under age 5 and three from 5 to 14 years.
Drug-resistant cases increased from 9.5 percent in 2003 to 10.3 percent last year. But multi-resistant cases dropped from 3.4 percent of all cases in 2003 to 0.9 percent last year.
"Our goal is to significantly reduce the incidence of tuberculosis within Hawaii's population, and we're confident Dr. Wing and her colleagues are on the right path," said Malcom Koga, the American Lung Association-Hawaii president.