Before effective treatments were introduced in the 1950s, tuberculosis was a leading cause of death and disability in the United States. Health care workers were at particular risk. Although the occupational risk of tuberculosis has been declining in recent years, this new book from the Institute of Medicine concludes that vigilance in tuberculosis control is still needed in workplaces and communities. Tuberculosis in the Workplace reviews evidence about the effectiveness of control measuresâ€"such as those recommended by the Centers for Disease Control and Preventionâ€"intended to prevent transmission of tuberculosis in health care and other workplaces. It discusses whether proposed regulations from the Occupational Safety and Health Administration would likely increase or sustain compliance with effective control measures and would allow adequate flexibility to adapt measures to the degree of risk facing workers.

This document is an evidence-based policy for the implementation of sound tuberculosis (TB) infection control by all stakeholders. The evidence base for the policy was established through a systematic literature review. The review highlighted some areas where evidence supports interventions that add value to TB infection control. A number of recommendations were developed, based on this evidence and on additional factors, such as feasibility, programmatic implementation and anticipated cost.

At the beginning of the 20th century, Ireland was one of the very few developed countries to be experiencing a rise in tuberculosis mortality, which was rapidly declining in the rest of the British Isles. Jones (history, U. of Ulster at Jordanstown, Northern Ireland) traces the history of the disease from that point to the 1950s when mortality rates had fallen to a level commensurate with other developed countries. She explores the social and economic factors for the disparity, and examines if the history of the disease in Ireland can shed light on the nature of tuberculosis epidemics in general. Her conclusions, while not reducible to simple formulations, suggest that public health campaigns, demographics of urbanization, nutrition levels, and economic disparity are all factors that should be explored in epidemiological investigations of tuberculosis. Annotation copyrighted by Book News, Inc., Portland, OR

Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.