New WHO Guidelines to Tackle TB

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Sarah Peddie

New recommendations from the World Health Organisation (WHO) aims to prevent tuberculosis (TB) and save millions of lives around the world. 

This new guidance will help countries accelerate their efforts to stop people with TB infection becoming sick by giving them preventive treatment. 

Around a quarter of the world’s population is said to be infected with TB bacteria - but these people are neither sick or contagious. They are however, at risk of developing TB disease and especially those with weakened immune systems. 

By offering people preventive treatment will protect them from becoming sick and also cut down the risk of spreading the disease throughout a community. 

TB remains to be one of the world’s top infectious killers with 10 million people falling ill with the disease in 2018 and 1.5 million dying from the disease. 

Dr Tedros Adhanom Ghebreyesus, WHO Director General commented: “The world committed to end TB by 2030; improving prevention is key to making this happen. 

"Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives".

Dr Tedros highlighted how important it is to continue to tackle health problems like TB during the COVID-19 outbreak. 

However, programmes that have been set up to tackle TB and other infectious diseases can be leveraged to make the response to COVID-19 more effective and fast.

The new guidelines set out by the WHO:

  • WHO recommends a scale-up of TB preventive treatment among populations at highest risk including household contacts of TB patients, people living with HIV and other people at risk with lowered immunity or living in crowded settings.
  • WHO recommends an integration of TB preventive treatment services into ongoing case finding efforts for active TB. All household contacts of TB patients and people living with HIV are recommended to be screened for active TB. If active TB is ruled out, they should be initiated on TB preventive treatment.
  • WHO recommends that either a tuberculin skin test  or interferon-gamma release assay (IGRA) be used to test for TB infection. Both tests are helpful to find people more likely to benefit from TB preventive treatment but should not become a barrier to scale-up access. Testing for TB infection is not required before starting TB preventive treatment in people living with HIV, and children under 5 years who are contacts of people with active TB.
  • WHO recommends new shorter options for preventive treatment in addition to the widely used 6 months of daily isoniazid. The shorter options that are now recommended range from a 1 month daily regimen of rifapentine plus isoniazid to 3 months weekly rifapentine plus isoniazid, 3 months daily rifampicin plus isoniazid, or 4 months of daily rifampicin alone.

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