Prevention and control of tuberculosis: a review
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Tuberculosis is again becoming a major public health problem. In order to control this complex disease, case-management, chemoprophylaxis and vaccination are used. The aim of case-management is to virtually stop transmission of tuberculosis infection by multidrug chemotherapy. This is, however, hampered by poor drug compliance and the high cost of the most effective drugs. Bacilli-Calmette-Guerin (BCG) vaccination has been used for a long time but with contentious efficacy. Though recent studies put the efficacy at 50%, its cost-effectiveness has yet to be established. Isoniazid preventive therapy (1PT) for control of tuberculosis is also rapidly gaining acceptance. In patients who adhere to 80% of medication taken, the efficacy is usually high. As for the control of tuberculosis among health care workers, engineering, administrative and personal respiratory measures have been introduced. Following the introduction of these measures in USA, dramatic decline in the risk of tuberculosis among these workers has occurred.