The new National Tuberculosis Control Programme in Israel, a country of high immigration.
METHODS
Israel has implemented a new tuberculosis (TB) control programme in response to the rise in the incidence of tuberculosis due to immigration in the last decade. It complies with World Health Organization guidelines, and also includes specific measures addressing the needs of immigrants. We describe the new programme and compare the outcome of treatment prior and after its realisation.


METHODS
Each component of the new strategy was scrutinised, aspects that did not function well were identified and how we contended with these issues is described. Analysis of outcome of treatment was according to WHO/IUATLD definitions.


RESULTS
Better and clearer organisation of TB treatment in all its aspects, including cultural sensitivity, has been obtained. Compliance improved from less than 27% for successful outcome before the new programme to more than 75% after. In addition to the improvement in completion rates, the universal use of directly observed treatment has ensured enhanced adherence.


CONCLUSIONS
Using legislative, administrative and budgetary measures, as well as clinical guidelines published by the Ministry of Health, the TB infrastructure in Israel has been successfully reorganised. The decision to do so was not only clinically and organisationally justifiable, it is also economically viable.
Chemtob
D
D
Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel. daniel.chemtob@moh.health.gov.il
Leventhal
A
A
Berlowitz
Y
Y
Weiler-Ravell
D
D
D000995:Antitubercular Agents / Q000627:therapeutic use*; D003140:Communicable Disease Control / Q000331:legislation & jurisprudence*; D003466:Cultural Characteristics; D004641:Emigration and Immigration; D006291:Health Policy; D006801:Humans; D007557:Israel; D010349:Patient Compliance; D011057:Politics; D017410:Practice Guidelines as Topic; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*
D000995:Antitubercular Agents