This manual constitutes policies, protocols, and recommendations for the Chest Clinics of the Bureau of Tuberculosis Control, New York City Department of Health. The protocols cover the common as well as complex clinical issues that arise in the control of tuberculosis. The policies are based on the recommendations of the Centers for Disease Control and Prevention, American Lung Association, American Thoracic Society, as well as the opinions of local and national experts in tuberculosis. While an attempt has been made to have this manual be comprehensive, protocols cannot and should not substitute for clinical judgement. However, for most patients, strict adherence to clinical protocols will result in improved patient care, and consequent control of tuberculosis.
Opinions vary for many issues in tuberculosis control, including resistant tuberculosis, etc.
Bureau of Tuberculosis Control Chest Clinic clinicians, as well as others referring to this manual, are strongly encouraged to seek consultation for issues pertaining to individual cases which may not be fully discussed here. The mission of the Bureau of Tuberculosis Control is to prevent the spread of tuberculosis and eliminate it as a public health problem in New York City. The Bureau achieves its goals through direct patient care, education, surveillance and outreach. The contents of the manual have been divided into ten sections which encompass issues relating to the evaluation and treatment of active TB, including multidrug-resistant TB preventive treatment screening for TB infection and contact evaluation. The International Classification of Tuberculosis has been used wherever appropriate.