Tuberculosis Epidemiology and the Need to Review Policy Priorities for Its Management

Abstract

Controlling tuberculosis requires understanding the epidemiological pattern of the disease and identifying populations at risk. A review of epidemiological data from a study in Isfahan province showed that about one-third of the identified patients are foreign nationals, especially Afghan immigrants, who have a lower average age than Iranian patients. In addition, the geographical distribution of cases is not the same in different cities of the province. According to the study findings, existing control strategies need to be reviewed. To respond to this challenge, five policy strategies were proposed. First, implementing an active screening program in the foreign national population in cooperation with the Nationals Administration and NGOs, while ensuring the security and confidentiality of their information. Second, designing and implementing periodic screening in industrial workers in coordination with the Labor Administration and employers, and using mobile health teams. Third, strengthening the surveillance system and actively searching for tuberculosis cases to compensate for undiagnosed cases during the pandemic. Fourth, identifying close contacts of married patients and treating latent tuberculosis in children under 6 years of age as an effective preventive intervention. Fifth, screening the elderly population, especially residents of care centers, by sending mobile teams. The implementation of the proposed strategies also faces implementation obstacles, including the fear of immigrants being rejected, employers' resistance to workers' absenteeism, burnout of health personnel, lack of awareness among families, and the mobility restrictions of the elderly. Considering these obstacles, the prioritization of strategies was proposed as follows: first, strengthening the surveillance system as the main infrastructure, then screening the immigrant population considering their high share, then treating latent tuberculosis in children, and in the next stages, screening industrial workers and the elderly should be included in the implementation process. © 2026, null. All rights reserved.