Spotting latent infection: the path to better tuberculosis control

Abstract

Tuberculosis (TB) control is based on prevention as well as prompt diagnosis and treatment of active TB. Since the latter is usually accomplished quite effectively in developed countries, and since BCG vaccination is of limited effectiveness, better TB control will require improved diagnosis and preventative treatment of latent tuberculosis infection (LTBI).^{1– 3} The reservoir of latently infected individuals is much larger than the number of active TB cases, and includes recently infected contacts of pulmonary TB cases and immigrants from high prevalence regions who acquired infection in their country of origin. This latter group is becoming increasingly important because over half the burden of TB in many low prevalence countries is carried by immigrants,^{3– 5} and because several higher prevalence countries will soon join the European Union.