Evidence based tuberculosis control: a public health care approach

Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual pat ients. One of the differential traits of the practice of public health when compared to clinical medicine is that it does not concentrate in individua l patients, but rather in the health problems of the population in a given time. In public health interventions, besides the importance of efficacy, a spects related to the process of implementation become also crucial, This p aper develops some principles for evidence-based public health, which are t hen applied to a given problem: tuberculosis control in our context, Tuberc ulosis control poses challenges which go beyond clinical practice, and requ ire a collective organized effort. This is precisely what makes it a public health issue and not only a clinical problem, as it requires not only heal th care dimensions but also public health dimensions, which require policie s that are feasible, have high efficacy, and a moderate cost, To illustrate the problem and the results of public health policies, available data and indicators are used, with special reference to the authors experience in th e program for the prevention and control of tuberculosis in Barcelona (Cata lonia, Spain).