Treatment

Recommendations 1.1–1.4

Justification 

The recommendations on TB care and support are as follows:

The Recommendations part of this chapter has three main sections on elements of TB care and support. The elements covered are:

WHO 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.

1. The End TB Strategy. Geneva: World Health Organization; 2015 (https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy).
2. WHO consolidated guidelines on drug resistant tuberculosis treatment. Geneva: World Health Organization; 2019 (https://apps.who.int/iris/bitstream/handle/10665/311389/9789241550529-eng.pdf).

In addition to summarizing the available evidence, the reviews undertaken for these consolidated guidelines revealed several gaps in current knowledge about critical areas in DR-TB treatment and care. The estimates of effect for patient studies were commonly assigned a low or very low certainty rating, which explains why most of the recommendations in these guidelines are conditional. Some gaps identified in previous TB treatment guidelines (2, 16) persist.

Recommendation 8.1 HCV and MDR/RR-TB treatment

Remarks

1. This recommendation applies to people with confirmed MDR/RR-TB and HCV.
2. Treatment initiation should take into account potential DDI and other comorbidities.

Rationale

Recommendation 7.1 Surgery for MDR/RR-TB patients

Justification and evidence

The recommendation in this section addresses one PICO question: