[The role of institutions for the prevention of tuberculosis: organization, relation with the DDASS (Regional Public Health System), and physicians].

The role of institutions in the prevention of tuberculosis was defined according to the May 4, 1995 government guidelines no 41 relating to the organization of prevention against tuberculosis. These guidelines were made following the modifications brought by the January 18, 1994 public health law and are recommendations made by the French Higher Council of Public Health. This role must also take into account of the recent modifications introduced by the Code of Public Health article L. 3113-1 (law of January 1, 1995), as well as May 6, 1999 decrees no 99-362 and 99-363, and May 16, 2001 decree no 437. It is essential to identify risk groups in developed countries: people in poor socio-economical conditions, migrant population coming from strongly endemic countries, people infected by HIV or other immunodepressive diseases, and people living in institutions like prisons, long stay institutions, or old people's homes. These groups can include more than 60% of all TB cases. They need to be acknowledged for the fight against TB to be effective. The surveillance of tuberculosis remains the State's responsibility.