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To the Editor: Dr Heymann and colleagues¹ emphasized the need for global action against drug-resistant tuberculosis (TB). We agree that this should be an important part of a comprehensive action plan aimed at controlling and eventually eliminating TB, but we have 2 points of disagreement. First, we disagree with their claim that "where effective DOTS [directly observed treatment, short-course] programs have been in place . . . ," multidrug-resistant TB (MDRTB) "remained unchanged or increased." Contrary to their mention of Korea as having an "effective DOTS program" that has not altered "the prevelance of MDRTB," reports in Korea's regular nationwide prevalence surveys show a decrease in both TB prevalence from 668 per 100,000 in 1965 to 93 per 100,000 in 1995 and its drug resistance, from 38% in 1965 to 9.9% in 1995.²

We also question whether "the incidence of MDRTB will increase if the disease is left untreated and . . . [Full Text of this Article]

RELATED ARTICLE

The Need for Global Action Against Multidrug-Resistant Tuberculosis
S. Jody Heymann, Timothy F. Brewer, Mary E. Wilson, and Harvey V. Fineberg
JAMA. 1999;281(22):2138-2140.
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