New WHO recommendations to prevent tuberculosis

As we mark World TB Day 2020, the disease remains the world’s top infectious killer. In 2018, 10 million people fell ill with TB worldwide and 1.5 million people lost their lives to this disease.

“COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be,“ said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “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."

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The new consolidated guidelines recommend a range of innovative approaches to scale up access to TB preventive treatment:

• 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.

Read more:

New WHO recommendations to prevent tuberculosis aim to save millions of lives
WHO Consolidated guidelines on tuberculosis
WHO Operational handbook on tuberculosis
World TB Day 2020