Approaches to contact investigations in Texas.

Tuberculosis (TB) spreads when family and social contacts breathe the air exhaled by someone with active TB disease. Contact investigation is the most appropriate strategy to interrupt the transmission and subsequent development of TB. One of the problems associated with contact investigations in an area with a very diverse population has been the inability of investigations to adapt their methods of approach to the different circumstances of each person with TB disease. Through interviews and group discussions with public health field workers and local TB program managers across Texas, the authors have been able to gather information on how contact investigation practices can be customized to overcome barriers specific to different populations in the state and generate a productive outcome. Variables such as culture, language, risk factors, and various settings may require a different investigational approach than the standard, traditional approach to contact investigation. It is anticipated that the concept of customizing contact investigations to meet the needs of specific populations and circumstances will become the practice worldwide, and will be a useful tool in the management of contact investigations.