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Role of the Health Department in Tuberculosis Prevention and Control—Legal and Public Health Considerations

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  • Authors: Carla Jeffries1, Phil Lobue2, Terence Chorba3, Beverly Metchock4, Ijaz Kashef5
  • Editor: David Schlossberg6
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333; 2: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333; 3: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333; 4: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333; 5: Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA 30333; 6: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0034-2016
  • Received 05 December 2016 Accepted 09 December 2016 Published 03 March 2017
  • Carla Jeffries, hhx3@cdc.gov
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  • Abstract:

    Because tuberculosis is caused by an infectious organism that is spread from person to person through the air, public health measures are essential to control the disease. There are three priority strategies for tuberculosis prevention and control in the United States: (i) identifying and treating persons who have tuberculosis disease; (ii) finding persons exposed to infectious tuberculosis patients, evaluating them for infection and disease, and providing subsequent treatment, if appropriate; and (iii) testing populations at high risk for latent tuberculosis infection (LTBI) and treating those persons who are infected to prevent progression to disease. These strategies for prevention and control of tuberculosis are discussed in a framework containing the following important topics: historical and epidemiological context of tuberculosis control, organization of public health tuberculosis control programs, legal basis for public health authority, conducting overall planning and development of policy, identifying persons who have clinically active tuberculosis, evaluation of immigrants, managing persons who have or who are suspected of having disease, medical consultation, interjurisdictional referrals, identifying and managing persons infected with , providing laboratory and diagnostic services, collecting and analyzing data, and providing training and education. This chapter describes the role of the health department in the context of these components. This discussion is primarily applicable to tuberculosis prevention and control programs in the United States.

  • Citation: Jeffries C, Lobue P, Chorba T, Metchock B, Kashef I. 2017. Role of the Health Department in Tuberculosis Prevention and Control—Legal and Public Health Considerations. Microbiol Spectrum 5(2):TNMI7-0034-2016. doi:10.1128/microbiolspec.TNMI7-0034-2016.

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2017-03-03
2017-11-22

Abstract:

Because tuberculosis is caused by an infectious organism that is spread from person to person through the air, public health measures are essential to control the disease. There are three priority strategies for tuberculosis prevention and control in the United States: (i) identifying and treating persons who have tuberculosis disease; (ii) finding persons exposed to infectious tuberculosis patients, evaluating them for infection and disease, and providing subsequent treatment, if appropriate; and (iii) testing populations at high risk for latent tuberculosis infection (LTBI) and treating those persons who are infected to prevent progression to disease. These strategies for prevention and control of tuberculosis are discussed in a framework containing the following important topics: historical and epidemiological context of tuberculosis control, organization of public health tuberculosis control programs, legal basis for public health authority, conducting overall planning and development of policy, identifying persons who have clinically active tuberculosis, evaluation of immigrants, managing persons who have or who are suspected of having disease, medical consultation, interjurisdictional referrals, identifying and managing persons infected with , providing laboratory and diagnostic services, collecting and analyzing data, and providing training and education. This chapter describes the role of the health department in the context of these components. This discussion is primarily applicable to tuberculosis prevention and control programs in the United States.

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Figures

Image of FIGURE 1
FIGURE 1

Tuberculosis screening medical examination for applicants ≥2 years of age in countries with a WHO-estimated tuberculosis incidence rate of ≥20 cases per 100,000 population.

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0034-2016
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Image of FIGURE 2
FIGURE 2

TB regional training and medical consultation centers (TB RTMCCs).

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0034-2016
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Tables

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TABLE 1

Selected cases involving relevant constitutional provisions

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0034-2016
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TABLE 2

National tuberculosis program objective categories

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0034-2016
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TABLE 3

Possible components of a multifaceted, patient-centered treatment strategy

Source: microbiolspec March 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0034-2016

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