Family tuberculosis contacts: resource-contingent management

Recent findings in tuberculosis research have questioned the efficacy of bacille Calmette-Guérin (BCG) vaccination and demonstrated the effectiveness of combined-drug chemotherapy and isoniazid (INH) chemoprophylaxis, both in regimens of under 12 months duration. Because of the renewed emphasis on drug treatment in tuberculosis control, family physicians and the health personnel they supervise need to be involved in this effort. Despite differences in health care resources in different regions, rational and effective management of active cases and their contacts in the family can be devised. While the priority remains treatment of the active index case, family physicians have a unique opportunity to utilize family relationships to find and to treat other active cases and to reinforce compliance with INH chemoprophylaxis by high-risk family contacts.