Tubercular threat

The city’s hepatitis A crisis continues unabated, and now the county health department is looking for a contractor to help tame a cross-border tuberculosis threat. “Among clients who are diagnosed with tuberculosis in San Diego, an estimated 40 clients per year require services on both sides of the US-Mexico border,” says a December 5 request for quotation regarding the provision of so-called Directly Observed Therapy services. “Limited resources in Tijuana, Rosarito and the east towards Tecate make it difficult for these clients to reliably receive outreach services. Failure to ensure directly observed therapy and to manage household contacts can adversely affect efforts to control TB in the border region.”

The contractor will be required to “notify TB Control staff within one working day of all episodes where a client misses two or more doses in one week or one dose per week for three subsequent weeks.” The vendor must also notify officials if a TB patient “is lost to the program (no forwarding address), enters an institution where [Directly Observed Therapy] cannot be continued, or moves out of the jurisdiction.”

No putative cost for services is provided. Per the website PSN en Linea, Tijuana reports three times the average rate of TB in Mexico and has the highest mortality rate in the country.