The control of tuberculosis in Scotland brings together the various current expert professional guidelines on tuberculosis, and seeks to ensure a consistency of approach in the detection, control and treatment of this disease. The original need for this document was created by the distinct differences in practical arrangements that exist between Scotland and the rest of the UK, but this also presented the opportunity to harmonise existing multiple sources of guidance, and to suggest new approaches to issues where there is currently no agreed policy.
The document falls into five sections:
- Background information on the need for these Scottish guidelines and on the national and international evolution of the tuberculosis epidemic.
- Surveillance mechanisms, including the current arrangements for statutory notification of cases, laboratory reporting and submission of samples, national surveillance, and the communications network essential for effective public health action.
- Prevention, diagnosis and management of cases; this section deals with the practical issues encompassing screening tests, vaccination, laboratory diagnosis, notification of cases, antibiotic treatment (including management of multi-drug resistant strains), tracing and management of contacts of cases, and management of outbreaks and major incidents.
- Special situations where particular groups of people require a more specialised approach, namely children, the homeless, HIV-infected persons, immigrants and emigrants; those in institutional and similar settings (including prisons, hospitals, nursing/residential homes and the workplace); those with occupational risks (including healthcare staff and those in contact with animals).
- Other aspects of importance in the fight against tuberculosis, namely education and training of healthcare staff, audit of clinical and epidemiological protocols and practice, the need for ongoing research, and the necessity of ensuring that local and national services are adequately resourced to maximise health gain.