Tuberculosis: current issues in diagnosis and treatment.

The incidence of tuberculosis began to decline in 1801, which was probably due to improving socioeconomic conditions (certainly not the efforts of the medical profession). Patients cannot be treated unless they are detected, which underlines the importance of notification and case finding. Full multiagent chemotherapy is necessary to give the best chance of permanent cure and to prevent the emergence of resistance; compliance with treatment is increased by making it readily accessible and increasing the degree of supervision. With the resurgence of interest in tuberculosis since the rising incidence of the late 1980s a review of the state of diagnosis and treatment is due. This one covers some areas of current interest: the role of vaccination, chemoprophylaxis, tuberculosis and HIV, new methods of diagnosis, drug resistance and alternative approaches to treatment.