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Chapter 13 : Role of the Health Department—Legal and Public Health Considerations

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Abstract:

This chapter describes the role of the health department in the context of the core components of public health tuberculosis control programs that were identified by the Advisory Council for the Elimination of Tuberculosis (ACET). This discussion is primarily applicable to tuberculosis prevention and control programs in the United States. State and local public health departments must work with their legal counsel to ensure that their actions comport with constitutional provisions and their jurisdiction’s legal authorities to prevent and control tuberculosis. The first priority of tuberculosis control in the United States is detection and treatment of patients with active tuberculosis. After a patient with tuberculosis has been reported to the health department, it is the responsibility of the health department, in conjunction with the patient’s medical provider, to ensure that the patient completes an adequate treatment regimen. In addition to core services, public health laboratories should provide or ensure availability of nucleic acid amplification to detect complex directly in clinical specimens, when clinically indicated for patients for whom a diagnosis of tuberculosis is being considered but has not yet been established, and for whom the test result would alter case management or tuberculosis control activities. Tuberculosis control programs should analyze the data collected to monitor morbidity trends, determine the demographic characteristics of their patient population, monitor drug resistance rates, and determine the outcomes of treatment. Finally, the chapter provides tuberculosis training and education.

Citation: Thombley M, Ijaz K, Metchock B, LoBue P. 2011. Role of the Health Department—Legal and Public Health Considerations, p 224-241. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch13

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Figures

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Figure 1.

1991 TB TI.

Citation: Thombley M, Ijaz K, Metchock B, LoBue P. 2011. Role of the Health Department—Legal and Public Health Considerations, p 224-241. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch13
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Image of Figure 2.
Figure 2.

2007 TI for tuberculosis screening and treatment for applicants in countries with WHO-estimated tuberculosis incidence rates of ≥20 cases per 100,000 population.

Citation: Thombley M, Ijaz K, Metchock B, LoBue P. 2011. Role of the Health Department—Legal and Public Health Considerations, p 224-241. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch13
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Image of Figure 3.
Figure 3.

RTMCCs: areas of coverage.

Citation: Thombley M, Ijaz K, Metchock B, LoBue P. 2011. Role of the Health Department—Legal and Public Health Considerations, p 224-241. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch13
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References

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Tables

Generic image for table
Table 1.

Selected cases involving relevant constitutional provisions

Citation: Thombley M, Ijaz K, Metchock B, LoBue P. 2011. Role of the Health Department—Legal and Public Health Considerations, p 224-241. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch13
Generic image for table
Table 2.

National tuberculosis program objective categories

Citation: Thombley M, Ijaz K, Metchock B, LoBue P. 2011. Role of the Health Department—Legal and Public Health Considerations, p 224-241. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch13
Generic image for table
Table 3.

Possible components of a multifaceted, patient-centered treatment strategy

Citation: Thombley M, Ijaz K, Metchock B, LoBue P. 2011. Role of the Health Department—Legal and Public Health Considerations, p 224-241. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch13

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