Prevention in Areas of Risk
Prevention of tuberculosis (TB) is most important in immumocompromised individuals and those in health care facilities. Since person-to-person transmission is usually from inhaling infected aerosol droplets, group activities such as singing and close dancing in institutions should be discouraged. Persons with a chronic cough should don a barrier to block the projectile aerosol droplets. Visitors should be screened for suspicious symptoms such as a positive cough history or travel to a TB-endemic area.
Prevention in Hospitals
In hospitals, use of isolation is protocol in those with positive skin testing or a history of primary TB. Healthcare workers and visitors should use a mask effective as a barrier for aerosolized droplets.
Diabetics should practice strict glycemic control. Those on systemic steroids or who are immunosuppressed (HIV) should practice caution in crowded places.
Prevention in High Risk Individuals
Those who are at increased risk for reactivation–HIV or anyone with prior primary TB–should be followed closely by his or her primary care physician for diagnostic tests that can identify active disease at the earliest opportunities. Those on systemic corticosteroids should be reminded of their risk so that they can report any chronic cough or acute dyspnea that develops.
Prevention in the Household
The best strategy for preventing TB from passing from household member to member is effective treatment of the TB of the affected individual. This means support of compliance for the intensive phase and continuation phase of therapy.