The World Health Organization (WHO) released new guidelines that aim to help countries accelerate tuberculosis (TB) preventive treatment, at a time when 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, according to a statement from the WHO.
“COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be,“ Tedros Adhanom Ghebreyesus, WHO Director-General, said in a statement. “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”.
Tedros highlighted the importance to continue efforts to tackle longstanding health problems, including TB during global outbreaks such as COVID-19. At the same time, programs already in place to combat TB and other major infectious diseases can be leveraged to make the response to COVID-19 more effective and rapid.
The new guidelines recommend a range of 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.
“As people around the globe come together to commemorate World TB Day, WHO is calling on governments, affected communities, civil society organizations, health-care providers, donors, partners and the industry to unite forces and step up the TB response – notably for TB preventive treatment – to ensure no one is left behind,” said Tereza Kasaeva, director of WHO’s Global TB Programme. “The new WHO guidance shows the way forward for millions to rapidly access new tools and shorter, safer options for preventive treatment. The time for action is now.”