Consolidated Guidelines

The second edition of the WHO guidelines on TPT provides a comprehensive set of recommendations for PMTPT for implementers of the WHO End TB Strategy and also for countries working towards TB elimination (8,9). The guidelines are to be used primarily in national TB and HIV and maternal and child health programmes or their equivalents in ministries of health and by other policy-makers working on TB, HIV, infectious diseases and maternal and child health.

Advanced HIV disease: for adults, adolescents, and children aged 5 years or more, “advanced HIV disease” is defined as a CD4 cell count of less than 200 cells/mm³ or a WHO clinical stage 3 or 4 event at presentation for care. All children with HIV aged under 5 years should be considered as having advanced disease at presentation.

Age groups: the following definitions for adults and children are used in these guidelines for the purpose of implementing recommendations (countries may have other definitions under their national regulations)² :

Before being considered for group membership, each Guideline Development Group (GDG) and External Review Group candidate was required to submit a completed declaration of interest (DOI) form. In addition, a preliminary internet search was performed to identify any obvious public controversies or interests that may lead to compromising situations for the World Health Organization (WHO) and the expert concerned.

Current recommendations on the various methods and tools should not prevent or restrict further research on new, rapid molecular drug-susceptibility tests, especially for assays that can be used as close as possible to where patients with a presumptive diagnosis of TB are identified and where treatment can be initiated. Priorities for further operational research on diagnostics are listed below, grouped for each technology.

Molecular assays intended as initial tests

The target audience for these guidelines includes laboratory managers, clinicians and other health care staff, HIV and TB programme managers, policy-makers, technical agencies, donors and implementing partners supporting the use of TB diagnostics in resource-limited settings.

Individuals responsible for programme planning, budgeting, mobilizing resources and implementing training activities for the programmatic management of DR-TB may also find this document useful.