Tuberculosis in Greenland--still a problem to bear in mind: development and strategy.

OBJECTIVES: Tuberculosis is still a disease to be taken seriously in Greenland. After a ten-year period in oblivion, the incidence of tuberculosis has been shown to be rising during the nineties. A central tuberculosis-group was constituted in 1997 in order to monitor and control the situation. A centrally placed TB nurse was established to support and supervise local health authorities. STUDY
DESIGN: Retrospective review of registered incidents of tuberculosis from all health districts from 1997 until 2002. Review of reports from the TB nurse.
METHODS: Quality assessment of treatment and subsequent control was systematically conducted by the TB nurse.
RESULTS: Microepidemics were observed in various health districts. The TB nurse was a positive assistance in case finding, tracking sources of infection, identifying disease carriers, guidance and instruction of local health care workers. Knowledge of TB and continuity amongst health care workers along with a fragile manning situation are shown to be important determining factors in the effort to control TB. With a former high prevalence of TB hidden pools may still be likely to turn up.
CONCLUSION: Health care workers still need to focus on tuberculosis in order to diagnose individual incidents, to secure proper treatment according to guidelines, to track sources of infection, to identify disease carriers, and to prevent further spreading into the community. The interventions of the TB nurse are an efficient tool to control microepidemics at a local level in seeing that proper registration, treatment and specific prophylactic interventions are being carried out.