Consolidated Guidelines

5. Key principles

The Nutrition Guidance Advisory Group agreed on five key guiding principles¹ that should be considered together with the evidence-informed recommendations. The principles are intended to inform and assist national technical groups, international and regional partners providing TB care, TB treatment services, and/or maternal and child health services in countries affected by TB, in formulating national or subnational nutritional recommendations.

3. Scope of the current update

The WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment include recommendations for the four milestones in the cascade of preventive care, namely identification of risk groups, TB screening and ruling out TB, testing for TBI, and choice and administration of the TPT regimen. The second edition of the TPT guidelines will have the same scope.

1. Scope and purpose

The aim of this guideline is to help improve health outcomes for people with tuberculosis (TB), through improved nutritional care and support. The objectives of the guideline are to provide guidance on nutritional assessment, advice and treatment, for integration into clinical care for people with TB. Five guiding principles for nutritional care and support for people with TB are presented. The focus is on nutrition assessment, counselling and management to improve the clinical care of people with TB.

1.2 TB screening and ruling out TB disease

Giving TPT to someone who has TB disease can delay resolution of disease and favour the emergence of drug resistance. Excluding TB disease before initiating preventive treatment is one of the critical steps in the TBI care pathway. This section proposes approaches for ruling out TB disease and diagnosing TBI in people at risk of TB according to HIV status, symptoms, household contact, other risk factors, age, TBI test results and abnormality on CXR (Fig.1).

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