Review - Reviewer's Assessment

1. Short summary / abstract
This guidance updates the previous control and prevention guidelines published in 1994. New data available in areas such as infection control, bovine tuberculosis, the risks of transmission of tuberculosis during air travel and the changing epidemiology of tuberculosis in the UK has made this update necessary.
The code of practice includes guidance on: -
Public health law
Organisation of tuberculosis services
Control of tuberculosis in specific settings and amongst high risk groups-
- control of tuberculosis in hospitals
- protection of healthcare workers and other groups working with populations at particular risk of tuberculosis
- tuberculosis in prisons
- tuberculosis in the elderly in long stay care
- tuberculosis in schools
- schoolteachers and others working with children
- homeless persons
- tuberculosis in aircraft
Contact tracing procedures
Bovine tuberculosis
Screening of immigrants
Outbreak investigation
BCG immunisation
A subgroup of the JTC (BTS) reviewed the previous guidance (1994) and new data from recent epidemiology to produce this updated advice.

2. What question is the document addressing?
The document outlines the public health law and organisation of services for tuberculosis plus control and prevention of tuberculosis in specific settings and in high risk groups in the United Kingdom

3. Type of study
Review of previous guidelines and new published evidence

4. Methods valid & appropriate?

Guidance being updated at present?

5. Results / recommendations reliable?
Yes: Produced by a subcommittee appointed by the Joint Tuberculosis Committee of the British Thoracic Society which included representatives of the Royal College of Nursing, Public health Medicine Environmental Group and Medical Society for the Study of Venereal Diseases.
The guidelines have been approved by the JTC and the Standards of Care Committee of the BTS.
New publications were reviewed and the committee graded the strength of evidence for the recommendations.

6. Any major problems and biases?
Guidance being updated at present?

7. Any other important / relevant studies which confirm or contradict?
1. Department of Health. Stopping Tuberculosis in England: An Action Plan from the Chief Medical Officer October 2004
2. Joint Tuberculosis Committee of the British Thoracic Society: Chemotherapy and management of tuberculosis in the United Kingdom: recommendations. 1998 Thorax 1998; 53: 536-548
3. Joint Tuberculosis Committee of the British Thoracic Society: Code of Practice 1994, Thorax 1994; 49: 1193-1200
4. International Council of Nurses. TB Guidelines for Nurses in the Care and Control of Tuberculosis and Multi-Drug Resistant Tuberculosis. (2005)
The International Council of Nurses has launched an online Global TB Resource Centre ( ) – which provides multiple tools for both generalist and specialist nurses treating and caring for patients with tuberculosis and multi-drug resistant tuberculosis (MDR-TB)

8. Keywords
Tuberculosis BTS guidelines public health law health care workers protection contact tracing screening BCG vaccination immunisation notification surveillance outbreak multi-drug resistance chemoprophylaxis mycobacterium isolation bovine tuberculosis

Reviewer's Details:

Name:Sue Wiseman
Post:Nurse Consultant –Infection Control, DH
(Society / Organisation / Advisory Committee):
Member Advisory Committee on Dangerous Pathogens
Health Protection Adviser Royal College of Nursing P/T
Member Infection Control Nurses Association

*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.

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