Research into the control of tuberculosis and leprosy in the community

Abstract

Studies of the risk of tuberculous infection have increased the understanding of the epidemiology of the disease, and have assisted the evaluation of control methods in developed countries. The principal sources of infection are smear-positive cases, the main groups at special risk of disease are household and other close contacts of active tuberculosis and persons with inactive tuberculosis or fibrotic lesions. The merits of different case-finding procedures have been assessed. Close contacts of active tuberculosis should be screened; other at-risk groups should be encouraged to report if they develop symptoms; general population screening is unproductive. Early diagnosis and effective treatment reduces the risk of infection in the community more rapidly than effective vaccination. The lack of a test for leprosy infection has hindered similar research in leprosy, studies are now under way in Malawi. Tuberculosis control in developing countries is being studied in Tanzania.