Spanish-language series offers new educational tool for TB awareness

GAINESVILLE, Fla. — Teresa knocks on her friend’s door late one night.
“¿Qué pasa?” the friend worriedly asks.

“My husband is still sick,” she responds, as the friend offers Teresa a jar of honey, the only “remedy” at hand for the husband’s ongoing cough, fever, and night-sweats.

That is how the first chapter begins of the Spanish-language novela “¡Vivir a Todo Pulmón!” or “Live Life to the Fullest!,” a 40-page recently released series that addresses misconceptions about tuberculosis, or TB, to better inform communities vulnerable to the disease.

Modeled after the storyline of a stereotypical Latin-American soap opera, the “fotonovela” is less high-drama and more reality TV.

“The idea was to create a story understandable to a Latino audience, but identifiable to the Mexican community,” said Dr. Paula Hamsho-Diaz, a physician with the Southeastern National Tuberculosis Center, part of the University of Florida College of Medicine and UF Emerging Pathogens Institute. “Proportionately, there are more foreign-born cases of TB and that’s why these resources are useful.”

Nearly 10 million new cases of TB appear worldwide each year and about 2 million people will die from the disease. The Florida Department of Health estimates that about 900 people will get active TB this year in the state, and that 60 percent of these cases are among people born in countries with a high incidence of TB, including Latin America and the Caribbean.

In the fotonovela, which is similar to a graphic novel but uses photographs instead of drawings, Teresa accompanies her husband to doctor’s office visits, social events and Mass on Sundays — scenarios in which they then address the concerns and stigmas that family members, friends or co-workers living with TB might face. Hamsho-Diaz led the team that created the fotonovela, which took three years to develop and evaluate how appropriately cultural themes were incorporated into the story.

“This is definitely something you can have on the kitchen table,” said Joseph Brueggen, a disease intervention specialist in Immokalee, Fla.

Brueggen, who educates mostly Spanish-speaking migrant workers about the importance of medication compliance if they contract the illness, added that the novela was the best educational tool he’s used in his more than 25-year career.

“I’ve noticed that it really touches these people in their ordinary lives, and this is important because sometimes a person’s immigration status deters them from going to a health clinic,” he said.

Tuberculosis is an airborne disease caused by strains of mycobacteria that attack the lungs and pose a range of symptoms for people who acquire the illness, most notably a characteristic chronic cough often accompanied by blood-tinged sputum. Although TB is treatable, new strains of the disease are showing resistance to currently available antibiotics, and a patient’s inability to stay on a medication regime promotes resistance in the organism.

However, experts caution that TB should not be seen as an illness exclusive to immigrant communities. In counties outside of Atlanta, for example, Georgia state health officials document a rise in TB among African-American men, who already have a national disease rate eight times above that of U.S.-born whites.

“Reaching out to groups with a high incidence of TB is critical to ensure that all of us are safe from this potentially life-threatening disease,” said Dr. Michael Lauzardo, director of the Southeastern National Tuberculosis Center and chief of the division of mycobacteriology in the UF College of Medicine. “Tuberculosis is a disease that cannot be considered truly controlled anywhere until it is controlled everywhere.”

The Southeastern National Tuberculosis Center is one of four national tuberculosis centers funded by the Centers for Disease Control and Prevention that provide TB training, education, and expert medical consultation to health professionals and TB Control Programs in the United States and abroad.

To access the fotonovela, visit




Claudia Adrien



Paula Hamsho-Diaz,, 352-273-7682



Michael Lauzardo,, 352-273-7682