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U.S. Department of Health and Human Services


Core Curriculum on Tuberculosis, 2000

Chapter 10
Community TB Control

Preventing and Controlling TB

State and local health departments have the primary responsibility for preventing and controlling TB. However, other health care providers who provide TB services in settings such as private clinics, managed care organizations, HIV clinics, correctional facilities, and hospitals also have responsibility for preventing and controlling TB in communities.

Prevention and control efforts should be conducted through the coordination of health care providers in a variety of settings to ensure the provision of direct services for TB patients. Prevention and control efforts should include three priority strategies:

  1. Identifying and treating all persons who have TB disease. This means finding cases of TB and ensuring that patients complete appropriate therapy;
  2. Finding and evaluating persons who have been in contact with TB patients to determine whether they have TB infection or disease, and treating them appropriately;
  3. Testing high-risk groups for TB infection to identify candidates for treatment of latent infection and to ensure the completion of treatment.

Health care providers offering direct services for TB patients should achieve the three priority strategies by working in cooperation with the local health department in the following areas:

TB control programs should develop an overall TB control strategy in collaboration with local clinicians, professional societies, and volunteer organizations. Ideally, the plan should be developed by the state or local TB advisory council, in conjunction with community TB coalition representatives. This process includes periodic review of applicable local laws, regulations, and policies that aim to protect the public from TB to ensure that they are consistent with currently recommended medical and public health practices.

TB control programs should guide and oversee the TB control efforts of local institutions and practitioners (and local health departments where appropriate) to ensure that these efforts reflect the current standards of care and public health practice.

Health department staff or other experts may provide consultation on patient care such as treatment of drug-resistant TB, assessment of response to therapy, detection and management of adverse drug reactions, methods of ensuring adherence to therapy such as the use of directly observed therapy (DOT), laboratory methods, infection control practices, contact or outbreak investigations, and access to available resources.

TB control programs should seek the funding necessary for carrying out TB control activities, and they should educate policymakers about the local TB problem and local program priorities, needs, and objectives. Programs should have adequate and appropriate staff to meet their objectives.


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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