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Catherine D. DeAngelis, MD, MPH; Annette Flanagin, RN, MA

JAMA. 2004;292:1889.

Tuberculosis (TB) has been infecting and killing humans for more than 3000 years.¹ Despite the many advances of modern medicine, TB remains one of the world’s leading infectious causes of death. Currently one third of the world’s population is infected with the TB bacillus and approximately 2 million individuals die each year of TB,² with more than 90% of infections and deaths occurring in low- and middle-income countries.³ In 2000, an estimated 8.7 million new cases of TB were reported, and approximately 2% to 3% were multidrug-resistant.⁴ In addition, TB is the leading cause of morbidity and mortality among individuals infected with the human immunodeficiency virus (HIV),² who have a greater risk of developing the disease.⁵

While 23 countries account for 80% of all new TB cases, more than half are concentrated in 5 countries (Bangladesh, China, India, Indonesia, and Nigeria).⁶ However, no country is immune. The global persistence and resurgence of TB have been spurred by neglect of public health control measures, poverty, poor nutrition, population growth, immigration, poorly functioning health care systems, the rise of HIV, poor adherence to medication despite Directly Observed Treatment, Short-course (DOTS)⁷ or lack thereof, multidrug-resistance of the bacillus, lack of efficient field tests for screening and diagnosis, difficulty making diagnoses in children, and no new or better vaccines.⁸

In recognition of the global health importance of TB, JAMA will publish a theme issue on this topic on June 8, 2005. We invite authors to submit manuscripts reporting original research (including randomized clinical trials and high-quality observational research), systematic reviews, scholarly commentaries, and special communications addressing TB. Reports of basic science and translational research studies that provide insight to underlying mechanisms of TB infections and management are also welcome.

Topics of interest include interventions for prevention, improved methods of detection, direct therapeutic interventions, and ethical issues. Areas of interest include diagnosis and management of TB in people throughout the world (including children, individuals infected with HIV, women of reproductive age, refugees and immigrants, and other vulnerable populations), development of vaccines, ethical issues involved in clinical trials of testing, and successful public health interventions for prevention, diagnosis, and treatment of TB.

Authors should consult the JAMA Instructions for Authors for guidelines on manuscript submission and preparation.⁹ Manuscripts received before January 15, 2005, will have the best chance for acceptance for the theme issue on tuberculosis.

The UN Millennium Declaration was signed by 189 countries in 2000¹⁰ and was translated into 8 Millennium Development Goals. Three of the 8 goals are directly related to health, including TB. However, recent evidence shows that many low-income countries are unlikely to achieve the Millennium Development Goals by the target date of 2015.¹¹

Our goal for publication of a JAMA theme issue on TB is to stimulate authors to report their research and to enable clinicians, public health officials, and government officials to gain insights into TB so that it might be contained or, better, eradicated in the next generation.

AUTHOR INFORMATION
Editorials represent the opinions of the authors and THE JOURNAL and not those of the American Medical Association.

Author Affiliations: Dr DeAngelis is Editor-in-Chief and Ms Flanagin is Managing Senior Editor, JAMA.

REFERENCES
1. Nerlich AG, Haas CJ, Zink A, et al. Molecular evidence for tuberculosis in an ancient Egyptian mummy. Lancet. 1997;350:1404. WEB OF SCIENCE | PUBMED 2. Tuberculosis. Available at: http://www.who.int/mediacentre/factsheets/fs104/en. Accessed September 22, 2004. 3. The Global Fund to Fight AIDS, Tuberculosis and Malaria. The global tuberculosis epidemic. Available at: http://www.theglobalfund.org/en/about/tuberculosis. Accessed September 20, 2004. 4. Jaramillo E. DOTS-Plus and the Green Light Committee. Presented at: "Meet the Expert" Session of the 33rd IUATLD World Conference on Lung Health; Montreal, Quebec; 2002. 5. Wood R, Maartens G, Lombard CJ. Risk factors for developing tuberculosis in HIV-1-infected adults from communities with a low or very high incidence of tuberculosis. J Acquir Immune Defic Syndr. 2000;23:75-80. PUBMED 6. WHO Report 2001: Global Tuberculosis Control. Geneva, Switzerland: World Health Organization; 2002. 7. What Is DOTS? A Guide to Understanding the WHO-Recommended TB Control Strategy Known as DOTS. Geneva, Switzerland: World Health Organization; 1999. Publication WHO/CDS/CPC/TB/99.270. 8. Mark Doherty T. New vaccines against tuberculosis. Trop Med Int Health. 2004;9:818-826. FULL TEXT | PUBMED 9. JAMA Instructions for Authors. JAMA Web site. Available at: http://jama.com. Accessed September 23, 2004. 10. United Nations Millennium Declaration: resolution adopted by the General Assembly (55/2). September 8, 2000. Available at: http://www.un.org/millennium/declaration/ares552e.htm. Accessibility verified September 24, 2004. 11. Clemens MA, Kenny CJ, Moss TJ. The Trouble With the MDG’s: Confronting Expectations of Aid and Development Success. Washington, DC: Center for Global Development; 2004. Working paper 40.

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