Guidelines on the Management of Latent Tuberculosis Infection.
- 1st ed.
- 1 online resource (38 pages)
Cover -- Contents -- Acknowledgements -- Abbreviations -- Declaration and management of conflict of interest -- Executive summary -- 1. Background and process -- 1.1. Background -- 1.2. Scope of the guidelines -- 1.3. Target audience -- 1.4. Development of the guidelines -- 1.5. Quality of evidence and strength of the recommendations -- 2. Recommendations -- 2.1. Identification of at-risk populations for LTBI testing and treatment -- 2.1.1. Summary of the evidence -- 2.1.2. Balance of benefits and harms -- 2.1.3. Values and preferences of clients and health-care providers -- 2.1.4. Resource considerations -- 2.2. Algorithm to test and treat LTBI -- 2.2.1. Summary of the evidence -- 2.2.2. Balance of benefits and harms -- 2.2.3. Values and preferences of clients and health-care providers -- 2.2.4. Resource considerations -- 2.3. Treatment options for LTBI -- 2.3.1. Summary of the evidence -- 2.3.2. Balance of benefits and harms -- 2.3.3. Values and preferences of clients and health-care providers -- 2.3.4. Resource considerations -- 2.4. Preventive treatment for contacts of MDR-TB cases -- 2.4.1. Summary of the evidence -- 2.4.2 Balance of benefits and harms -- 2.4.3. Values and preferences of clients and health-care providers -- 2.4.4. Resource considerations -- 2.4.5. Conclusions -- 3. Issues in Implementation -- 3.1. Adverse events monitoring -- 3.2. Risk of drug resistance following LTBI treatment -- 3.3. Adherence and completion of preventive treatment -- 3.4. Ethical considerations -- 3.5. Cost effectiveness -- 3.6. Programme management, monitoring and evaluation -- 4. Research gaps -- 4.1. Risk of progression to active TB disease and differential impact by population risk group -- 4.2. Defining the best algorithm to test and treat LTBI -- 4.3. Treatment options for LTBI and adverse event monitoring. 4.4. Risk of drug resistance following LTBI treatment -- 4.5. Adherence and completion of treatment -- 4.6. Cost-effectiveness studies -- 4.7. Preventive treatment for MDR-TB contacts -- 4.8. Programme management -- 5. References -- 6. Annexes -- Annex 1: List of primary target countries for the guidelines -- Annex 2: List of systematic reviews conducted -- Annex 3: Recommended drug dosage.
Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB. A direct measurement tool for M. tuberculosis infection in humans is currently unavailable. The vast majority of infected persons have no signs or symptoms of TB but are at risk for developing activetuberculosis (TB) disease. This can be averted by preventive treatment. These Guidelines on the management of latent tuberculosis infection were developed in accordanceto the requirements and recommended process of the WHO Guideline Review Committee andprovide public health approach guidance on evidence-based practices for testing treating andmanaging LTBI in infected individuals with the highest likelihood of progression to active disease.The guidelines are also intended to provide the basis and rationale for the development of nationalguidelines. The guidelines are primarily targeted at high-income or upper middle-income countrieswith an estimated TB incidence rate of less than 100 per 100 000 population. Resource-limited andother middle-income countries that do not belong to the above category should implement theexisting WHO guidelines on people living with HIV and child contacts below 5 years of age.