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This is an archived document. The links are no longer being updated.

Core Curriculum on Tuberculosis, 2000

What the Clinician Should Know
4th. Ed., 2000
Chapter 1


In 1989, the Centers for Disease Control and Prevention (CDC) announced the goal of eliminating tuberculosis (TB) from the United States by the year 2010. The Strategic Plan for the Elimination of Tuberculosis in the United States was published at that time, and reassessed in 1999, to identify the actions necessary to achieve elimination. In 1992, a special federal task force was convened to address the problem of increasing case rates and outbreaks of drug-resistant TB. This task force developed the National Action Plan to Combat Multidrug-Resistant Tuberculosis, which enhanced the original Strategic Plan. Both plans stress the need to increase clinical knowledge about TB disease and infection.

Since 1993, TB case rates have been declining, suggesting that the nation is recovering from the resurgence of TB that occurred in the mid-1980s, and is back on track toward TB elimination. While the decrease in TB case rates is encouraging, there are several areas of concern that will require expanded efforts:

  • TB cases continue to be reported in every state
  • Drug-resistant TB cases continue to be reported in almost every state
  • An estimated 10 to 15 million persons in the U.S. are infected with Mycobacterium tuberculosis. Without intervention, about 10 % of these persons will develop TB disease at some point in life.

An update on TB for clinicians is critical today. The occurrences of several outbreaks of multidrug-resistant TB have pointed to the need for new treatment regimens and the more effective use of current ones. New methods of diagnosis have been introduced, and guidelines for patient management and public health practice have been revised.

This curriculum was designed to present basic information about TB for health care professionals. It is intended for use as a reference manual for clinicians caring for persons with or at high risk for TB disease or infection. In addition, it was designed to be useful in developing educational programs. It is not meant to provide detailed answers to all public health or clinical questions about TB, nor is it meant as a substitute for any specific guidelines. Information contained in this document is current as of April 2000.

In preparing this document, our aim was to meet the following goals:

  • To increase clinicians’ knowledge of the current TB trends.
  • To assist clinicians with identifying those at highest risk for TB infection and disease.
  • To increase clinicians’ index of suspicion for TB in high-risk patients.
  • To increase clinicians’ use of treatment for high-risk persons with latent TB infection.
  • To increase clinicians’ knowledge about appropriate and effective treatment regimens.
  • To increase clinicians’ use of directly observed therapy (DOT) and other adherence-promoting methods.
  • To assist clinicians with identifying appropriate measures to prevent TB transmission in health care settings.
  • To assist clinicians with identifying resources for patients with TB.

This document was originally developed by the 1989 National Tuberculosis Training Initiative, 1 cosponsored by the American Thoracic Society and CDC. Because the guidelines for treating and controlling TB continue to evolve, it has been necessary to periodically revise this curriculum. The current document is the fourth edition of the Core Curriculum on Tuberculosis.

Continuing education credits [continuing medical education (CME) credits, continuing nursing education (CNE) credits, and continuing education unit (CEU)] are available for this publication.  


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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