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Guidelines on the management of latent tuberculosis infection.

Author: Global Tuberculosis Programme,; World Health Organization,
Publisher: Geneva : World Health Organization, [2015]
Edition/Format:   eBook : Document : International government publication : EnglishView all editions and formats
Summary:
BACKGROUND: Latent tuberculosis infection (LTBI), defined as a state of persistent immune response to prior-acquired Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB, affects about one-third of the world's population. Approximately 10% of people with LTBI will develop active TB disease in their lifetime, with the majority developing it within the first five years after initial  Read more...
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Genre/Form: Guideline
Electronic books
Additional Physical Format: Print version:
WHO.
Guidelines on the Management of Latent Tuberculosis Infection.
Geneva : World Health Organization, ©2015
Material Type: Document, Government publication, International government publication, Internet resource
Document Type: Internet Resource, Computer File
All Authors / Contributors: Global Tuberculosis Programme,; World Health Organization,
ISBN: 9789241548908 9241548908 9789240693524 9240693521
OCLC Number: 899158487
Notes: "The End TB Strategy."
"WHO/HTM/TB/2015.01"--Page 2 of cover.
Description: 1 online resource (1 PDF file (33 pages)) : illustrations
Contents: 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 LTBI2.2.1. 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 2.4.4.4.4. 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 monitoring4.4. 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.

Abstract:

BACKGROUND: Latent tuberculosis infection (LTBI), defined as a state of persistent immune response to prior-acquired Mycobacterium tuberculosis antigens without evidence of clinically manifested active TB, affects about one-third of the world's population. Approximately 10% of people with LTBI will develop active TB disease in their lifetime, with the majority developing it within the first five years after initial infection. Currently available treatments have an efficacy ranging from 60% to 90%. Systematic testing and treatment of LTBI in at-risk populations is a critical component of WHO's eight-point framework adapted from the End TB Strategy to target pre-elimination and, ultimately, elimination in low incidence countries. OVERVIEW: Recognizing the importance of expanding the response to LTBI, in 2014 WHO developed Guidelines on the Management of Latent Tuberculosis Infection. The guidelines are primarily targeted at high-income or upper middle-income countries with an estimated TB incidence rate of less than 100 per 100 000 population, because they are most likely to benefit from it due to their current TB epidemiology and resource availability. The overall objective of the guidelines is to provide public health approach guidance on evidence-based practices for testing, treating and managing LTBI in individuals with the highest risk of progression to active disease. Specific objectives include identifying and prioritizing at-risk population groups for targeted intervention of LTBI testing and treatment, including defining an algorithm, and recommending specific treatment options. The guidelines are expected to provide the basis and rationale for the development of national guidelines for LTBI management based on available resources, epidemiology of TB including intensity of transmission, the health-care delivery system of the country, and other national and local determinants.

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