Duration of Effective Tuberculosis Treatment, not Acid-Fast Bacilli (AFB) Smear Status, as the Determinant for Deisolation in Community Settings

For decades, multiple public health and clinical tools have been used to prevent tuberculosis (TB) transmission.Two of these tools are directly discussed in the document by the National Tuberculosis Coalition of America (NTCA) in this issue of Clinical Infectious Diseases: (1) prompt and effective TB disease treatment and (2) isolation, or separating persons with TB disease from others until non-infectious.Use of nucleic acid amplification tests can facilitate rapid TB diagnosis, rapid detection of drug resistance, and early effective treatment [1,2]; prompt TB treatment initiation is beneficial to both the person with TB and the community.The risk-benefit equation for isolation of persons with TB after treatment initiation, however, is not as straightforward; in this situation, persons with TB bear the burden of isolation, with potential benefit from preventing transmission accruing to the community.