Operational Handbooks

TPT falls broadly into three categories: (i) isoniazid monotherapy for 6 or 9 months (6H or 9H), (ii) rifamycin-based shorter treatment and (iii) Lfx for 6 months (6Lfx) for people exposed to MDR/ RR-TB. Isoniazid preventive treatment (IPT) for 6 months was the mainstay of TPT until recently, for both adults and children, HIV-positive and HIV-negative, and in high and low TB incidence countries. Several systematic reviews have consistently demonstrated the efficacy of IPT in preventing TB disease among people infected with M. tuberculosis.

The structure of the network and the testing packages available at each level should be tailored to meet the needs of the community and the local epidemiology of TB. When considering placement of a diagnostic test, targets to be considered should be demand based rather than population based and should include:

LPAs are a family of DNA strip-based tests that detect mutations associated with drug resistance. They do this either directly, through binding DNA amplification products (amplicons) to probes targeting the most commonly occurring mutations (MUT probes), or indirectly, inferred by the lack of binding the amplicons to the corresponding wild-type probes.

Successful implementation of the plan will require financial and human resource commitments from the ministry of health (MoH) or national tuberculosis (TB) programme (NTP), with possible support from implementing partners. Consider integrating TB testing on existing multidisease platforms in locations where integrated testing is feasible, to share costs across disease programmes. A budget should be developed to address activities in collaboration with key partners, using the considerations outlined below. Technical assistance may be needed.

The predictive values of a test vary depending on the prevalence of TB in the population being tested. Table 3.1 provides examples of population-level projections of the results of testing with the various mWRDs in settings with different levels of TB prevalence, based on pooled sensitivity and specificity estimates that were extracted from the WHO consolidated guidelines on tuberculosis. Module 3: Diagnosis – rapid diagnostics for tuberculosis detection, 2021 update (13) for each test.