Tuberculosis Prevention and Control Activities

1. Identify and treat all persons who have acute Tuberculosis.
2. Contact investigation: contact investigations are important in for identifying persons who have acute Tuberculosis and infected persons at high risk for developing Tuberculosis.
3. Screening population at high risk for Tuberculosis to locate persons infected and giving complete therapy to prevent the infection from progressing to active contagious disease.

High Risk Groups

Based on reports and CDC surveillance data, the advisory council for the Elimination of Tuberculosis (ACET) recommends that the following groups should he screened for Tuberculosis and Tuberculosis infection:

• Persons with close contact (i.e. those sharing the same household or other enclosed environment ) of persons known or suspected to have Tuberculosis
• Persons infected with HIV.
• Persons who have medical risk factors known to increase the risk for disease if infection occurs.
• Residents and employees of high risk in congregate settings (e.g. nursing homes, etc.).
• Health care workers who serve high risk clients.
• Foreign born persons, including children who are recently arrived (within 5 years) from countries that have high Tuberculosis incidence and prevalence rate.
• Some medically under-served low income populations.
• High risk racial or ethnic minorities population, as defined locally.
• Infants children and adolescents exposed to adults in high risk categories

Screening methods

The Mantoux test (i.e. the intra-cutaneous administration of five units of Purified Protein Derivative (PPD) ) that detects infections.
The positive predictive value of the Tuberculin test is low. If cut off of >10 mm. is used to define a positive test.
Routine screening is not recommended for population at low risk of infection with Tuberculosis.
Post-vaccination BCG induced Tuberculin reactivity ranges from no duration to an indication of 19 mm. At the skin test site.
Tuberculin reactivity caused by BCG vaccination wanes with the passage of time and is unlikely to persist 10 years after vaccination in the absence of Microbacteria Tuberculosis.