英语翻译

英语翻译
Discussion
The use of RIF/PZA among immigrants in this out-break was associated with a high incidence of hepato-toxicity,a completion rate well below the CDC’s 85%target,（5） and cultural and financial barriers to treatment and monitoring.
The 17% of adults experiencing a drug-induced hepatitis is consistent with prior reports among non–HIV-infected persons.（10,14）The incidence of hepatotoxicity in clinical trials of non–HIV-infected persons is approximately 8%（14）; however,other health departments have reported higher rates.（15,16）Differences may be due to differences in patient populations,monitoring,and definitions of hepatitis.While this experience confirms the importance of close monitoring,the health department found that linguistic barriers and cultural beliefs about giving blood hindered monitoring and may have decreased adherence.
The key limitation to this study is the small number of subjects,which does not allow for population inferences,comparisons with clinical trials,or a full exploration of risk factors for hepatitis.Reliance on chartbased data and self-reports may have underestimated prevalence of comorbidities and alcohol use during treatment and contributed to the high rate of hepatotoxicity.While there were limited side effects and a high completion rate for children,4 months of ri-fampin remains the standard of care in children exposed to isoniazid-resistant tuberculosis because of limited data on RIF/PZA in children.（5,13）The costs associated with RIF/PZA are underestimated because follow-up testing and interpreter time were not included.
This case study may assist healthcare providers facing similar decisions about tuberculosis prevention in recent immigrants.Resources should be directed toward improving the healthcare system’s ability to provide culturally appropriate care because this may improve adherence to current,less-toxic therapies.（4,17–19）Although mobile immigrants may benefit from short-course preventive therapy,potential benefits must be weighed against potential hepatotoxicity,cost,and cultural barriers.
We are grateful to Karen Grush,Jane Lux,and Ana Rodriguez at the DeKalb County Health Department,and Margaret Swartz and Vicki Biddle at the Illinois Department of Public Health for their gracious assistance and collaboration.We would also like to thank Marshall Chin and John Lantos at the University of Chicago for their helpful advice on the manuscript.This research was supported by a grant from the Robert Wood Johnson Foundation.