Consolidated Guidelines

Among individuals infected with M. tuberculosis, it is estimated that the average lifetime risk of progressing to TB disease is about 5–10% (4). The risk is particularly elevated among children under 5 years and among people with compromised immunity (1). As any treatment entails risk of harms and opportunity costs, TPT should be selectively targeted to population groups at highest risk of progression to TB disease, who would benefit most.

Note: The definitions listed below apply to the terms as used in these guidelines. They may have different meanings in other contexts.

Active case finding (ACF): is synonymous with systematic screening for tuberculosis (TB) disease, although usually implemented outside a health facility.

Adolescent: is a person aged 10–19 years.

Adult: is a person aged > 19 years.

WHO guidelines on TPT are premised on the probability that TBI will progress to TB disease in specific risk groups, on the underlying epidemiology and burden of TB and on the feasibility and the public health benefit of the intervention. WHO global policy is expected to provide the basis for the development of national guidelines for PMTPT, adapted to local circumstances. These guidelines envisage a massive extension of TPT, including to individuals exposed to MDR/RR-TB, whereas global coverage of the intervention is still very low, even in priority target groups (10).

Tuberculosis infection (TBI) is defined as a state of persistent immune response to stimulation by M. tuberculosis antigens with no evidence of clinically manifest TB disease (1). As there is no “gold standard” test for TBI, the global burden is not known with certainty; however, about one fourth of the world’s population is estimated to have been infected with M.