FeedbackWHO aims to use the best available evidence on interventions to ensure adequate patient care and support and in order to inform policy decisions made by national TB control programme managers, national policy-makers and medical practitioners in a variety of geographical, economic and social settings.
This chapter of the WHO consolidated guidelines. Module 4: Treatment and care aims to provide a summary of existing WHO recommendations on care and support during tuberculosis treatment.
The recommendations included in this chapter were developed by three Guidelines Development Groups (GDGs) convened by the WHO Global Tuberculosis Programme in 2011, 2016 and 2021 (1–3) in order to review the evidence available on key aspects of TB care and support (see Annex 7). The GDGs were composed of a multidisciplinary group of TB experts external to WHO.
The recommendations were formulated by the GDGs using the GRADE approach. The recommendations were then reviewed by external review groups which were composed of experts and end-users from all WHO regions.
The Global TB Programme (GTB) of the World Health Organization (WHO) has been combining all current recommendations into one overall set of consolidated guidelines on TB. The guidelines contain recommendations regarding all areas related to the programmatic management of TB (e.g. screening, preventive treatment, diagnostics, the treatment of drug-susceptible and drug-resistant TB, patient care and support). The consolidated guidelines contain modules specific to each programmatic area.
The consolidated WHO evidence-based guidelines for the treatment of drug-resistant TB (4), for the treatment of drug-susceptible TB (DS-TB) (5), and for the management of tuberculosis in children and adolescents (3) were published in 2020 and 2022. The recommendations on tuberculosis care and support contained in these guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method for assessment of the quality of evidence.
People-centred care is an important element of the End TB Strategy which recommends treatment and patient support for all people with TB. Several interventions to support patients in their adherence to TB treatment have been implemented by national TB programmes for many years (e.g. treatment support with observation of medicine intake and social support), while others have been introduced recently (e.g. digital health interventions such as SMS messages, telephone calls or other reminders, and video-supported treatment, or VST). These interventions and models of care have been assessed using the GRADE method and WHO has issued guidelines with evidence-based recommendations for a variety of interventions for TB care and support. This chapter presents all WHO’s recommendations on TB care and support that are either newly developed or are existing recommendations that have been published previously in other WHO guidelines that applied the GRADE approach.