sons who, because of epidemiological circumstances, are at high risk of having latent tuberculosis infection. This is done by:
Analysis of local epidemiological data and targeting of high-incidence groups for specific screening projects.
Ensuring that patients, once identified via screening programs, have access to appropriate and adequate tuberculosis services. This again is dependent on the high-risk group being targeted and may require services being provided outside of the “traditional tuberculosis clinic” system.
Ensuring that patients are evaluated and placed on treatment for latent tuberculosis infection (as appropriate).
Ensuring their completion of therapy. Screening without followup does not serve the needs of the patients or public health.
Health departments attain these goals by structuring their tuberculosis services within the framework of essential functions as described in the Institute of Medicine report, The Future of Public Health (Institute of Medicine 1988). This framework includes assessment (epidemiology and surveillance), policy development, and assurance (patient and contact management and education and training). The methods by which these goals are addressed vary according to morbidity rates, public health infrastructure capacity, and resources.
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