Control strategies for tuberculosis and role of public health service

The best strategy of prevention of tuberculosis is to control the contact with tubercle bacilli, implement the suggested therapeutic protocol and verify the patient's compliance with the therapy. To this purpose, it is important to plan outpatient controls, supply enough drugs to the patient to last until the first outpatient control and include the patient in directly observed therapy (DOT) programs. At the hospital level there should be three possibilities: isolation of potentially contagious patients, application of structural devices and of respiratory protection. The role of the Public Health Service in the control of tuberculosis at present is of the utmost importance to optimize prevention measures as well as to prepare protocols for health care and therapy. Particular controls are necessary in health facilities providing care for HIV-positive subjects where a program of control of tuberculous infection should be implemented according to the guidelines of the Ministry of Health.