WHO operational handbook on tuberculosis. Module 1: prevention - tuberculosis preventive treatment.

Steve Graham (Center for International Child Health University of Melbourne, Australia) was a member of the External Review Group (ERG) for the 2020 guidelines. Background: About one fourth of the world’s population is estimated to be infected with the tuberculosis (TB) bacterium, and about 5–10% of those infected develop active TB disease in their lifetime. The risk for active TB disease after infection depends on several factors, the most important being the person’s immunological status. TB preventive treatment given to people at highest risk of progressing from TB infection to disease remains a critical activity to achieve the global targets of the End TB Strategy, as reiterated by the UN High Level Meeting on TB in 2018. Delivering treatment effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions. The WHO operational handbook on tuberculosis: tuberculosis preventive treatment is the companion, implementation guide to the 2020 WHO guidelines on TB preventive treatment.[1] Just as these guidelines are the first to be released under the rubric of the WHO consolidated TB guidelines, this handbook will be the first in a modular series of practical guides meant for the implementers of various aspects of the programmatic management TB. Overview: The handbook provides practical advice on how to put in place the WHO recommendations at the scale needed to achieve national and global impact. The chapters cover critical steps in programmatic management of TB preventive treatment following the cascade of preventive care: identifying individuals at highest risk, testing for infection, excluding active TB, choosing the treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance. The annexes include useful resources such as sample text for advocacy messaging, FAQs on testing for TB infection, considerations for coordination and budgeting for national strategic planning and resource mobilization. Although its focus is on high TB and HIV burden settings, the advice in the handbook is also relevant elsewhere. This book is intended to guide policy-makers within the ministries of health and other institutions, and stakeholders that have an impact on health, including HIV and TB programme managers at national, subnational and district levels; health care workers and staff of development and technical agencies, nongovernmental organizations as well as civil society and community-based organizations involved in supporting TPT services