Interventions for Tuberculosis Control and Elimination
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In conclusion of the presentation on interventions for tuberculosis control and elimination, there is universal agreement that chemotherapy is currently the most efficacious, effective, and efficient intervention. It has epidmeiological impact by shortening the duration of the natural duration of infectiousness and reduces thereby the incidence of infection with M tuberculosis in the community and thus reduces both the short-term, but even more strongly the long-term incidence of tuberculosis. It also immediately carries individual benefit by reducing fatality from the most extensive forms of pulmonary tuberculosis from 80% or 90% to some 5%.
Preventive therapy is an excellent concept to address the prevalence of infection with M tuberculosis, but its implementation is fraught with problems and because current tests cannot reliably identify persons who harbor life bacilli it is neither a very effective nor a very efficient intervention strategy.
Much remains unknown about the role of vaccination and the reasons why BCG sometimes provides rather high protection but with the same vaccine strain may give no protection at all. Vaccine development will require a much better understanding of these observations.
