ABSTRACT
Tuberculosis (TB) is a major public health concern in developing countries. Nearly one-third of
the world’s population is infected and this disease kills almost three million people per year,
more than any other infectious agent in the world. In the mid-1980s, there was a resurgence of
outbreaks in developed countries like the United States, largely due to the human immuno-
deficiency virus (HIV) epidemic, the development of drug-resistant strains, and the continued
legal and illegal immigration from endemic areas. Since 1953, when Center for Disease Control
(CDC) initiated public health surveillance for TB in the United States, the TB case rate has
declined almost 10-fold from 53 cases per 100,000 to 5.1 per 100,000 in 2003. However, the 1.3%
decline from 2002 to 2003 is the smallest yearly decline since 1992. Furthermore, for the first
time since 1989, TB deaths increased by 5% in 2002. This data indicates that TB remains a major
health problem even in developed countries like the United States (1).
