Materiały źródłowe

• #1 Prevention – Tuberculosis in Adults and Children – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK344409/

  Prevention is the key to stop transmission of TB. It consists of early diagnosis and treatment of active TB to stop infectiousness, the prevention of active disease in exposed or known latently infected individuals and vaccination. […] Vaccination with the Bacillus Calmette-Guerin (BCG) vaccine is unfortunately largely ineffective in interrupting transmission. However a more powerful vaccine will have the potential to cause a major shift in the management of TB. […] The standard regimen for treatment of latent TB infection is nine months isoniazid, also known as isoniazid prophylaxis therapy (IPT). […] A recent mass isoniazid prevention trial in South African mine workers showed no reduction in TB incidence and prevalence beyond the 9 months of IPT, suggesting that in high TB burden areas, transmission is not interrupted and the unchanged incidence is due to reinfection.

• #1 Tuberculosis Prevention: What to Do to Prevent TB

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/tuberculosis-prevention

  Tuberculosis (TB) prevention focuses on limiting your exposure to the disease. For people with TB, preventing the condition from spreading involves routine testing, isolation, and antibiotic therapy. […] Preventing TB generally requires extra care when traveling to regions where TB is widespread. […] Routine testing, vaccines, and isolation are all helpful tools in preventing the spread of TB. However, these measures are only necessary for some people. […] Additionally, the Bacille Calmette-Guérin (BCG) vaccine against TB is available for newborns in communities with widespread TB cases. […] In the U.S., local governments set their own prevention and management laws. Your local government may require you to isolate yourself from others if you have TB. However, people with LTBI do not require isolation because they cannot spread the disease.

• #1 Preventing Tuberculosis | Tuberculosis (TB) | CDC

  https://www.cdc.gov/tb/prevention/index.html

  People with inactive tuberculosis (TB), also called latent TB infection, can take treatment to prevent the development of active TB disease. […] People with active TB disease of the lungs or throat may need to take steps to prevent spreading TB germs to others. […] It is important for people to take all TB medicine exactly as prescribed. […] Infection control plans can minimize the risk for exposure to and spread of TB in health care settings. […] If you have inactive TB, treating it is the best way to prevent active TB disease. […] Without treatment, people with inactive TB can develop active TB disease. […] Some people with weakened immune systems (due to certain medications or health conditions) are at very high risk of developing active TB disease once infected with TB germs. It is very important that they receive treatment for inactive TB to prevent the development of active TB disease.

• #1 TB preventive therapy | Stop TB Partnership

  https://www.stoptb.org/what-we-do/accelerate-tb-innovations/introducing-new-tools-project/tb-preventive-therapy-tpt

  TB preventive therapy (TPT) is given to people who have been exposed to TB infection (e.g., household contacts), who are infected with TB bacteria (i.e., people with latent disease), or who are at higher risk of developing the disease than the general population (e.g., people living with HIV) to destroy any TB bacteria before the development of active disease. […] Medicines for TB preventive therapy are available at global access prices in Stop TBs GDF Medicines Catalog.

• #1 1.4 TB preventive treatment options | TB Knowledge Sharing

  https://tbksp.who.int/en/node/43

  TPTs for an infection with M. tuberculosis strains presumed to be drug-susceptible can be broadly categorized into two types: monotherapy with isoniazid for at least 6 months (IPT) and treatment with regimens containing a rifamycin (rifampicin or rifapentine). […] The following TB preventive treatment options are recommended regardless of HIV status: 6 or 9 months of daily isoniazid, or a 3-month regimen of weekly rifapentine plus isoniazid, or a 3-month regimen of daily isoniazid plus rifampicin. (Strong recommendation, moderate-to-high certainty of the estimates of effect). […] The following alternative TB preventive treatment options may be used regardless of HIV status: a 1-month regimen of daily rifapentine plus isoniazid or 4 months of daily rifampicin. (Conditional recommendation, low to moderate certainty of the estimates of effect).

• #1 Tuberculosis (TB) Guidelines: Latent Tuberculosis Infection (LTBI) Treatment Guidelines

  https://emedicine.medscape.com/article/230802-guidelines

  The recommended 2020 LTBI treatment guidelines include three preferred rifamycin-based regimens and two alternative daily-isoniazid monotherapy regimens. These recommendations are intended for Mycobacterium tuberculosis infections with presumed susceptibility to isoniazid or rifampin. M tuberculosis strains resistant to isoniazid and rifampin are exempt from these recommendations. […] Generally, rifamycin-based treatment regimens administered in short courses are preferred over isoniazid monotherapy administered in longer courses for treating LTBI. […] The rifamycin-based preferred regimens for LTBI are as follows: Once-weekly isoniazid plus rifapentine for 3 months (strongly recommended in adults and children 2 years, including those with HIV infection) OR Daily rifampin for 4 months (strongly recommended in HIV-negative adults and children of all ages) OR Daily isoniazid plus rifampin for 3 months (conditionally recommended in adults and children of all ages and HIV-positive persons).

• #1 1.4 TB preventive treatment options | TB Knowledge Sharing

  https://tbksp.who.int/en/node/43

  A strong recommendation for TPT alternatives to 6 months of daily isoniazid monotherapy (6H), based on evidence of moderate to high certainty, has featured in previous WHO guidance. […] Recommended TPT options are applicable in all settings, regardless of TB burden. […] The efficacy of 6H or more has been shown in different populations and settings in a number of systematic reviews. […] Until the 2020 updated guidelines, daily IPT for 36 months was conditionally recommended for adults and adolescents with HIV, regardless of whether they were receiving ART, in settings with a high risk of TB transmission. […] The GDG agreed that the benefits of all the treatment options being recommended outweigh their potential harm. […] The GDG agreed unanimously that, in individuals aged 15 years, the benefits of 3HR outweigh the harm, given the safety profile of this regimen, the higher rate of completion as compared with isoniazid monotherapy and the availability of child-friendly, fixed-dose combinations of rifampicin and isoniazid.

• #1 Isoniazid preventive therapy – Implementing the WHO Stop TB Strategy – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK310749/

  Treatment with isoniazid of TST-positive individuals living in settings with high prevalence of TB is highly efficacious in reducing the risk of developing active TB. Preventive therapy is therefore recommended for TST-positive individuals who do not have active TB. […] The risk of TB in individuals infected with both M. tuberculosis and HIV is much higher than for those without HIV infection, at 510% risk per year and 510% lifetime risk respectively. Treatment with isoniazid of individuals who are both TST- and HIV-positive, living in settings with high prevalence of TB, reduces the risk of developing active TB by around 60% (i.e. to around 40% of what it would have been without the treatment). […] TB and HIV control programmes should collaborate to ensure provision of IPT as part of the package of care for PLHIV when active TB has been excluded, and information about IPT should be made available to all PLHIV.

• #1 Conference on Retroviruses and Opportunistic Infections (CROI)

  https://www.healio.com/news/infectious-disease/20180305/1-month-of-tb-prophylaxis-as-effective-as-9-months

  1-month antibiotic regimen to prevent active tuberculosis in patients living with HIV was just as effective and caused fewer adverse events than a standard 9-month regimen, according to results of a phase 3 clinical trial presented at CROI. […] Prophylactic TB therapy is effective at preventing the development of active TB disease, according to researchers, but 6- to 9-month courses of daily isoniazid, which are standard in most countries, carry the risk of adverse events, such as liver damage. […] Both TB regimens were safe, and fewer adverse events were reported in the 1-month arm. […] A major problem with current latent TB treatment is the long duration and high rates of early discontinuation in clinical practice. […] If treatment can be cut down to 1 month, then patients have a greater chance for completion success and are less likely to develop side effects.

• #1 Isoniazid preventive therapy – Implementing the WHO Stop TB Strategy – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK310749/

  In populations with a high prevalence of TB, the duration of benefit following completion of a full six-month course of IPT is limited (up to 2.5 years). […] The use of preventive therapy in combination with ART for PLHIV may be beneficial but has not been fully evaluated. Preventive therapy given after a full course of anti-TB treatment has reduced the risk of recurrent TB in PLHIV in several settings, but did not prolong survival. […] WHO recommends treatment of active TB during pregnancy but has not developed recommendations on preventive therapy during pregnancy.

• #1 Isoniazid preventive therapy – Implementing the WHO Stop TB Strategy – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK310749/

  Preventive therapy, also known as chemoprophylaxis, with isoniazid reduces the risk of (i) a first episode of TB occurring in people exposed to infection or with latent infection and (ii) a recurrent episode of TB. […] WHO recommends isoniazid taken at a daily dose of 5 mg/kg (maximum 300 mg) for at least six months, and ideally for nine months. […] Preventive therapy has been used mainly for its beneficial effect in the individual. At a population level, mathematical modelling of community-wide preventive therapy in settings with a high burden of both HIV and TB suggests that this strategy may contribute to a reduction in the incidence of TB. […] The main groups for preventive therapy under programmatic conditions are those at most risk of progressing to TB disease. These are (i) PLHIV, (ii) infants and children who are contacts of TB patients and (iii) recent TST converters, since the risk of developing active TB is increased in the first few years.

• #1 Prevention – Tuberculosis in Adults and Children – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK344409/

  To avoid treating an active TB case with monotherapy, HIV-infected individuals should be screened for active TB before the administration of IPT. […] WHO recommends extended IPT (36 months) for individuals living in areas with a high background prevalence of HIV and TB. […] The reservoir of latently infected individuals is clearly a major barrier to eventual TB elimination, and shorter, less toxic regimens for latent TB will be a major boost to elimination efforts. […] Evidence to guide the choice of regimen for prophylactic treatment of the contacts of MDR and XDR TB patients is extremely limited. […] The American Thoracic Society (ATS) and the US Centers for Disease Control and Prevention (CDC) recommend prophylactic therapy for MDR TB contacts with the regimen to be used determined by the drug susceptibility profile of the potential source case.

• #1 Tuberculosis (TB) Treatment & Management: Approach Considerations, Treatment During Pregnancy, Treatment in Children

  https://emedicine.medscape.com/article/230802-treatment

  Pregnant patients with active TB should be treated, even in the first stage of pregnancy. Isoniazid, rifampin, and ethambutol may be used. In the United States, pyrazinamide is reserved for women with suspected multidrug-resistant TB (MDR-TB). Elsewhere in the world, pyrazinamide is commonly used in pregnant individuals with TB. Streptomycin should not be used because it has been shown to have harmful effects on the fetus. […] Preventive treatment is recommended during pregnancy, especially in the following types of patients: Pregnant patients with a positive tuberculin skin test result who are HIV seropositive or who have behavioral risk factors for HIV infection but who decline HIV testing […] Pregnant individuals with a positive tuberculin skin test result who have been in close contact with a patient who is smear-positive for pulmonary TB

• #1 Tuberculosis (TB) Treatment & Management: Approach Considerations, Treatment During Pregnancy, Treatment in Children

  https://emedicine.medscape.com/article/230802-treatment

  Pregnant patients who had a documented tuberculin skin test conversion during the previous 2 years. […] Pregnant individuals are at an increased risk for isoniazid-induced hepatotoxicity and should undergo monthly alanine aminotransferase (ALT) monitoring while on treatment. This risk continues 2-3 months into the postpartum period. Pyridoxine should also be administered to pregnant patients receiving isoniazid. […] The BCG vaccine continues to be used worldwide and usually protects early childhood. Immunity begins to wane, however, as early as 3 months after administration. […] In a meta-analysis of eight randomized controlled studies involving a total of 10,320 patients aged 15 years or younger, Ayieko et al found that isoniazid prophylaxis reduced the risk of developing TB, with a pooled risk ratio (RR) of 0.65 (P=0.004). However, isoniazid had no effect in children who initiated treatment at age 4 months or younger. When those patients were excluded, isoniazid prophylaxis reduced the risk of developing TB by 59% (RR,0.41; P 0.001).

• #1 Treatment for Latent Tuberculosis (TB) Infection Isoniazid and Rifapentine (INH-RPT) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/tb/basics/factsheets/inhrptltbi.html

  Your tests show that you have latent TB infection or LTBI. This means TB germs are in your body and could make you sick. […] You can take medicine to prevent getting active TB disease. Isoniazid and Rifapentine (INH-RPT) are medicines used together to treat LTBI. They kill the sleeping TB germs before they make you sick. […] If you dont take INH-RPT, miss too many days, or stop taking the medicine before your doctor or nurse tells you to, you may become sick with active TB disease. It is important to kill TB germs so you and your family stay healthy. […] If you have had BCG, you should still take medicine for LTBI to protect yourself and others. […] Remember to take your TB medicine as your doctor or nurse tells you. If you miss too many days, the medicine might not work. […] Do not drink beer, wine, or liquor, until you finish your LTBI treatment. Drinking alcohol while taking LTBI medicine can hurt your liver. […] Avoid becoming pregnant while taking INH-RPT. Call your doctor or nurse right away if you become pregnant.

• #1 1.4 TB preventive treatment options | TB Knowledge Sharing

  https://tbksp.who.int/en/node/43

  The GDG that prepared the 2020 update of the guidelines considered that there was moderate certainty that 4R is not inferior to 9H. […] The GDG noted that all the TPT regimens can be self-administered. […] In contacts exposed to multidrug- or rifampicin-resistant tuberculosis, 6 months of daily levofloxacin should be used as TB preventive treatment. (Strong recommendation, moderate certainty of the estimates of effect). […] It is thus important to take all measures possible to lower the risk of secondary cases of MDR/RR-TB. This includes use of appropriate TPT with regimens of proven effectiveness.

• #1 Tuberculosis Infection Control | TB Prevention in Health Care Settings | CDC

  https://www.cdc.gov/tb-healthcare-settings/hcp/infection-control/index.html

  A tuberculosis (TB) infection control plan is part of a general infection control program designed to ensure prompt detection of patients with infectious TB disease, airborne precautions, and treatment of people who have presumed or confirmed TB disease. […] The TB infection control program should be based on a three-level hierarchy of control measures: […] In all health care settings, particularly those in which people are at high risk for exposure to TB, policies and procedures for TB control should be developed, reviewed periodically (annually, if possible), and evaluated for effectiveness to determine the actions necessary to minimize the risk for transmission of TB. […] Administrative controls are the first and most important level of the hierarchy. These are management measures that are intended to reduce the risk or exposure to persons with infectious TB.

• #1 Tuberculosis Infection Control | TB Prevention in Health Care Settings | CDC

  https://www.cdc.gov/tb-healthcare-settings/hcp/infection-control/index.html

  The second level of the hierarchy is the use of environmental controls to prevent the spread of airborne TB bacteria by reducing the concentration of infectious droplet nuclei. […] The third level of the hierarchy is the use of respiratory-protection control. It consists of the use of personal protective equipment in situations that pose a high risk of exposure to TB disease (such as entering rooms with or transporting patients with presumed or confirmed infectious TB disease, cough-inducing, or aerosol-generating procedures). […] Use of respiratory protection equipment can further reduce risk the risk of infection of health care personnel with infectious droplet nuclei that have been expelled into the air from a patient with infectious TB disease. […] The Occupational Safety and Health Administration (OSHA) requires the development, implementation, administration, and periodic reevaluation of a respiratory protection program in health care settings.

• #1 Preventing Tuberculosis | Tuberculosis (TB) | CDC

  https://www.cdc.gov/tb/prevention/index.html

  If you have active TB disease of the lungs or throat, you may need to take steps to prevent spreading TB germs to other people. […] The most important way you can prevent the spread of TB is to take all medicines exactly as directed by your health care provider. […] Health care settings should have infection control plans to minimize the risk for exposure to and spread of TB. […] Treating inactive TB prevents active TB disease. […] Taking TB medicine as prescribed prevents drug-resistant TB disease. […] The most important way to prevent drug-resistant TB disease is to take all TB medicine exactly as prescribed.

• #1 Tuberculosis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250

  If you test positive for latent TB infection, you may need to take medicines to prevent active TB disease. […] If you have active TB disease, you’ll need to take steps to prevent other people from getting an infection. You will take medicines for four, six or nine months. Take all of the medicines as directed during the entire time. […] During the first 2 to 3 weeks, you will be able to pass TB bacteria to others. Protect others with these steps: Stay home. Don’t go to work or school. Isolate at home. Spend as little time as possible among members of your household. Sleep in a separate room. Ventilate the room. Tuberculosis germs spread more easily in small, closed spaces. If it’s not too cold outdoors, open the windows. Use a fan to blow air out. If you have more than one window, use one fan to blow air out and another to blow air in. Wear face masks. Wear a mask when you have to be around other people. Ask other members of the household to wear masks to protect themselves. Cover your mouth. Use a tissue to cover your mouth anytime you sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away. […] In countries where tuberculosis is common, infants often are vaccinated with the bacille Calmette-Guerin (BCG) vaccine. This protects infants and toddlers who are more likely to have active TB disease in the fluid surrounding the brain and spinal cord.

• #1 Prevention – Tuberculosis in Adults and Children – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK344409/

  The only vaccine currently available for TB is the bacillus Calmette-Guerin (BCG) vaccine developed by serial passage of Mycobacterium bovis and introduced in 1921. […] Clearly, given the huge burden of global TB and the major barrier to elimination that the silent reservoir of latently infected individuals represents, an effective TB vaccine would be a major advance in the battle to eradicate TB. […] The current pipeline includes three distinct approaches to the development of a TB vaccine, known as Prime, boost or immunotherapy. […] The key to maintaining the momentum towards achieving the STOPTB target of global TB eradication by 2050 will be sustained commitment from donors, governments, national TB programmes, researchers and other stakeholders at all levels of society.

• #1 TUBERCULOSIS: PREVENTION AND TREATMENT | Mya Care

  https://myacare.com/blog/tuberculosis-prevention-and-treatment

  The Bacillus Calmette-Gurin (BCG) vaccine is the most widely used TB vaccine. While it provides protection against severe forms of TB in children, such as miliary and meningeal TB, it does not fully protect against pulmonary TB, which is the most common form in adults. In regions where TB is prevalent, the BCG vaccine is given to infants to reduce the severity of the disease. […] In addition to the BCG vaccine, researchers are actively developing novel TB vaccines with the aim of providing more comprehensive protection against the disease. […] Cover your mouth when coughing or sneezing, especially if you have a persistent cough. […] Complete your treatment: People with active TB must take their full course of prescribed medications to avoid developing drug-resistant strains of TB and to prevent spreading the disease. […] If you have been in close contact with someone who has active TB, regular testing and monitoring are essential.

• #1 Tuberculosis (TB) Prevention & How To Prevent TB From Spreading

  https://www.webmd.com/lung/tuberculosis-prevention

  It may sound like a disease of the past, but tuberculosis, or TB, is still a real concern today. […] The best way to be well is to avoid getting sick in the first place. […] If you have active TB disease, you must get treated right away. This might involve taking a number of medications for 6 to 12 months. […] If you have TB germs in your body but they haven’t become active, you have what doctors call latent TB. […] Your doctor may still recommend that you take medications to keep the germs from becoming active. […] Follow these other tips to help prevent others from getting TB during your first few weeks of treatment, or until your doctor says you’re no longer contagious: […] In countries with high rates of TB infection, infants are often given the Bacillus Calmette-Gurin vaccine, (BCG). […] Doctors in the U.S. don’t generally recommend it because TB isn’t a widespread problem here. […] Still, healthcare workers who spend a lot of time around TB patients might benefit from the vaccine.

• #1 Tuberculosis – Wikipedia

  https://en.wikipedia.org/wiki/Tuberculosis

  In countries where tuberculosis is common, one dose is recommended in healthy babies as soon after birth as possible. […] A single dose is given by intradermal injection. Administered to children under 5, it decreases the risk of getting the infection by 20% and the risk of infection turning into active disease by nearly 60%. […] Public health campaigns that have focused on overcrowding, public spitting and regular sanitation (including hand washing) during the 1800s helped to either interrupt or slow the spread of the disease. […] The cascade of person-to-person spread can be circumvented by segregating those with active („overt”) TB and putting them on anti-TB drug regimens. […] The World Health Organization (WHO) declared TB a „global health emergency” in 1993, and in 2006, the Stop TB Partnership developed a Global Plan to Stop Tuberculosis that aimed to save 14 million lives between its launch and 2015. […] The goal of tuberculosis elimination is being hampered by the lack of rapid testing, short and effective treatment courses, and completely effective vaccines.

• #1 Management of tuberculosis – Wikipedia

  https://en.wikipedia.org/wiki/Management_of_tuberculosis

  Management of tuberculosis refers to techniques and procedures utilized for treating tuberculosis (TB), or simply a treatment plan for TB. […] Latent tuberculosis or latent tuberculosis infection (LTBI) is treated with three to nine months of isoniazid alone. This long-term treatment often risks the development of hepatotoxicity. A combination of isoniazid plus rifampicin for a period of three to four months is shown to be an equally effective method for treating LTBI, while mitigating risks to hepatotoxicity. Treatment of LTBI is essential in preventing the spread of active TB. […] DOTS stands for „Directly Observed Treatment, Short-course” and is a major plank in the World Health Organization (WHO) Global Plan to Stop TB. The DOTS strategy focuses on five main points of action. […] Treatment with properly implemented DOTS has a success rate exceeding 95% and prevents the emergence of further multi-drug resistant strains of tuberculosis.

• #1 Management of tuberculosis – Wikipedia

  https://en.wikipedia.org/wiki/Management_of_tuberculosis

  The WHO extended the DOTS programme in 1998 to include the treatment of MDR-TB (called „DOTS-Plus”). […] The treatment of latent tuberculosis infection (LTBI) is essential to controlling and eliminating TB by reducing the risk that TB infection will progress to disease. […] It is essential that assessment to rule out active TB is carried out before treatment for LTBI is started. To give LTBI treatment to someone with active TB is a serious error: the TB will not be adequately treated and there is a risk of developing drug-resistant strains of TB.

• #1 Tuberculosis – Eradication & Prevention

  https://www.gatesfoundation.org/our-work/programs/global-health/tuberculosis

  Our goal To accelerate the global decline in tuberculosis incidence. Better vaccines, drugs, and diagnostics are needed to reduce the burden of TB, which remains one of the leading causes of death worldwide. […] Current approaches to preventing, diagnosing, and treating TB are inadequate. […] The first step is prevention, and that means vaccinations. […] Our strategy The foundations Tuberculosis team aims to address key gaps along the TB care pathway through new approaches to protecting against infection, preventing progression from infection to disease, and improving diagnosis and treatment. […] A more effective vaccine would be the single most powerful tool to reduce the incidence of TB. Even a partially effective new vaccine, if introduced in 2024, could decrease TB incidence by up to 70 percent by 2050, according to some projections.

• #1 Webinar – Preventive Treatment of Tuberculosis to move toward elimination – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/events/webinar-preventive-treatment-tuberculosis-move-toward-elimination

  Tuberculosis (TB) remains a public health problem. TB preventive treatment (TPT) is considered one of the most important public health interventions to protect individuals and communities from TB. TPT is effective in reducing the incidence and mortality of TB disease. WHO-recommended regimens reduce the risk of disease progression by 60-90%, depending on the regimen prescribed. By reducing the number of people who develop active disease, preventive treatment also reduces the risk of drug-resistant TB. […] In March 2024, the WHO published the results of the feasibility study on investment in screening and preventive treatment of tuberculosis, prepared in collaboration with four countries, including Brazil, which showed that the application of screening and preventive treatment TPT can substantially reduce the incidence and mortality of this disease, and that modest investments could provide significant health and economic benefits, with a return on investment of up to $39 for every dollar invested.

• #1 Tuberculosis (TB) Treatment & Management: Approach Considerations, Treatment During Pregnancy, Treatment in Children

  https://emedicine.medscape.com/article/230802-treatment

  The public health sector should be notified and involved in cases of TB. Local county health departments are experts and funded in treating TB infection. Consultation with a primary care, pulmonology, internal medicine, or infectious disease specialist before initiating therapy is helpful, and it may be appropriate for this consultant to manage the antituberculous chemotherapy. Consult an expert on MDR-TB in cases of multidrug resistance.

• #1 The Tuberculosis Prevention Pipeline – Treatment Action Group

  https://www.treatmentactiongroup.org/resources/pipeline-report/2016-pipeline-report/the-tuberculosis-prevention-pipeline/

  The question of how to treat MTB infection among individuals exposed to DR-TB is one of the most vexing, and least studied, in TB prevention. […] To help fill this evidence gap, the AIDS Clinical Trials Group (ACTG) and the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) are collaborating on the PHOENIx study, which will enroll HIV-infected and uninfected child, adolescent, and adult household contacts of adults newly diagnosed with MDR-TB, pre-XDR-TB, and XDR-TB. […] Work to develop better TB prevention options for people with HIV is also progressing, and most of this work is revolving around rifapentine. […] The considerable potential of rifapentine to improve TB preventive therapy can only be unlocked if the drug becomes more widely available. […] Efforts to understand MTB persistence would benefit from initiating a dialogue with researchers involved in vaccine development about differences in how the TB drug and vaccine fields approach preclinical testing.

• #1 Tuberculosis – Eradication & Prevention

  https://www.gatesfoundation.org/our-work/programs/global-health/tuberculosis

  Improved diagnostic tools would reduce delays in starting treatment. A simpler, safer, shorter, and more affordable drug regimen would improve treatment success rates. New ways to use existing tools in order to identify patients early, link them to care, and facilitate faster and more effective treatment would help reduce the burden of TB. […] The drugs and diagnostics currently in clinical development can reach the people who need them most only if they are affordable and can be deployed efficiently. Substantial funding is needed for research and development, and investments from developed and TB-endemic countries, pharmaceutical companies, and foundations must be sustained.

• #1 The Tuberculosis Prevention Pipeline – Treatment Action Group

  https://www.treatmentactiongroup.org/resources/pipeline-report/2016-pipeline-report/the-tuberculosis-prevention-pipeline/

  Indeed, mathematical modeling shows that the dramatic reductions in TB incidence required to meet the TB elimination targets of the WHO’s End TB Strategy will require addressing TB infection—first through preventive therapy and then through vaccination. […] Developing new tools to prevent TB will require an intensification of basic science research that can inform product development. […] The central challenge in TB prevention research is that scientists have yet to establish a firm link between the appearance of any specific biomarker in individuals with asymptomatic MTB infection and progression to active TB disease. […] Once validated in late-stage clinical trials, a biomarker that could reliably predict disease progression or distinguish between individuals with high or low risk would be a powerful tool for guiding public health intervention efforts by identifying individuals most in need of preventive therapy, thereby creating opportunities to interrupt transmission by preempting disease progression.

• #1 Prevention of tuberculosis: When should contact persons receive preventive treatment? | German Center for Infection Research

  https://www.dzif.de/en/prevention-tuberculosis-when-should-contact-persons-receive-preventive-treatment

  In a large-scale systematic review, researchers from an international consortium analysed more than 25,000 publications from the last 20 years. They examined the circumstances under which contact persons of tuberculosis (TB) sufferers benefit from receiving preventive antibiotic therapy so that they do not fall ill themselves. The result showed that the effective strategy depends on the TB incidence of the country: in low-incidence countries, it makes sense to give preventive treatment only to those contact persons for whom a skin test or blood test shows evidence of contact with tuberculosis bacteria. In high-incidence countries, all close contacts of people with tuberculosis should receive preventive treatment if no tests are available. […] If it is suspected that you have been infected as a close contact person or if an immune test is positive, preventive treatment can be initiated. This prophylactic administration of antibiotics can be very useful in preventing a disease; however, due to the duration and side effects, it is not always advisable.

• #1 Prevention of tuberculosis: When should contact persons receive preventive treatment? | German Center for Infection Research

  https://www.dzif.de/en/prevention-tuberculosis-when-should-contact-persons-receive-preventive-treatment

  „As preventive antibiotic therapy is very effective, it should be used much more, especially in high-incidence countries,” says Prof Lange. „Until we have a better vaccine to protect against tuberculosis, preventive antibiotic treatment of contact persons is one of the most effective measures to prevent the spread of tuberculosis.”

• #1 Isoniazid preventive therapy completion in children under 5 years old who are contacts of tuberculosis cases in Lima, Peru: study protocol for an open-label, cluster-randomized superiority trial | Trials | Full Text

  https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-07062-6

  Education, counseling, incentives (monetary and non-monetary) and cultural case management may be effective for IPT completion, but results vary by context and underlying reasons for poor adherence. […] Weekly SMS reminders have shown promising results for IPT completion and adherence. […] Based on the limited evidence of interventions in medium incidence settings, we will conduct an open-label cluster-randomized superiority trial designed to test the effectiveness and implementation of an intervention package to increase information and motivation to complete IPT among children5 who have been prescribed IPT.

• #1 Press Release: Failure to implement contact tracing and tuberculosis prevention would result in close to 1 million deaths by 2035, according to new study – IMPAACT4TB

  https://impaact4tb.org/press-release-failure-to-implement-contact-tracing-and-tuberculosis-prevention-would-result-in-close-to-1-million-deaths-by-2035-according-to-new-study/

  People living in close contact with a person with TB disease are at highest risk of infection and account for a significant percentage of the 10.6 million new TB infections each year. […] Analysis shows that implementing a combined strategy of identifying household contacts and providing TB preventive treatment is cost-effective and would cut deaths by 35% among household contacts of all ages and people living with HIV by 2035. […] TB prevention and contact tracing can be delivered cost-effectively thanks, in part, to the significant price reductions in short-course therapy achieved in recent years. […] A new study published today in The Lancet Global Health found that the lives of 850,000 people could be saved by 2035 if short-course tuberculosis (TB) preventive treatment is provided to people living with HIV and contacts of individuals newly diagnosed with TB.

• #1 Press Release: Failure to implement contact tracing and tuberculosis prevention would result in close to 1 million deaths by 2035, according to new study – IMPAACT4TB

  https://impaact4tb.org/press-release-failure-to-implement-contact-tracing-and-tuberculosis-prevention-would-result-in-close-to-1-million-deaths-by-2035-according-to-new-study/

  The study, co-authored by researchers from Johns Hopkins University, the Aurum Institute and global health agency Unitaid, also found the combined intervention of contact tracing and TB prevention to be broadly cost-effective for household contacts of all ages. […] Although progress has been made in preventing TB among people living with HIV, we’ve lagged behind in keeping family members especially children free of the disease when a parent becomes sick. […] This new study, we hope, provides the evidence needed to massively scale up the use of TB preventive treatment among those individuals at risk of developing TB. […] The World Health Organization recommends TB preventive treatment for those at highest risk of infection, including people living with HIV and household contacts of people with TB.

• #1 Press Release: Failure to implement contact tracing and tuberculosis prevention would result in close to 1 million deaths by 2035, according to new study – IMPAACT4TB

  https://impaact4tb.org/press-release-failure-to-implement-contact-tracing-and-tuberculosis-prevention-would-result-in-close-to-1-million-deaths-by-2035-according-to-new-study/

  The imperative for TB prevention is clear, said Vincent Bretin, Director of Results at Unitaid. […] The study found that providing 3HP through contact tracing, in which the household members of a person diagnosed with TB are identified, assessed, and treated, could yield an estimated 13% cumulative reduction in the number of contacts developing TB through 2035 and an estimated 35% cumulative reduction in deaths. […] Among children under five, the combination of 3HP with contact tracing showed to have a profound impact on the child TB burden overall, helping to drive up the identification of active disease in addition to preventing new infections. […] The study is the first to provide comparable evidence on the cost-effectiveness of short-course TB preventive treatment for people living with HIV and household contacts in three age groups (5, 5-14, and 15 years old), using consistent methods for all four populations.

• #2

  https://www.healthxchange.sg/heart-lungs/lung-conditions/tuberculosis-tb-treatment-prevention-tips

  Early detection is your best protection against tuberculosis (TB). […] Go for a check-up if you suspect that you could be suffering from TB. […] Here are the measures you can adopt to help protect yourself and your loved ones from tuberculosis: Practice good hand hygiene – Wash your hands frequently with soap and water, and avoid touching your face. […] Wear a mask when going to crowded places. […] If someone you know has contracted TB, encourage him or her to adhere faithfully to the treatment. […] Complete the full course of your TB medications. […] Cover your mouth with a tissue when you cough or sneeze, and wear a face mask when around people during the first few weeks of treatment.

• #2 Tuberculosis (TB) Guidelines: Latent Tuberculosis Infection (LTBI) Treatment Guidelines

  https://emedicine.medscape.com/article/230802-guidelines

  The recommended 2020 LTBI treatment guidelines include three preferred rifamycin-based regimens and two alternative daily-isoniazid monotherapy regimens. These recommendations are intended for Mycobacterium tuberculosis infections with presumed susceptibility to isoniazid or rifampin. M tuberculosis strains resistant to isoniazid and rifampin are exempt from these recommendations. […] Generally, rifamycin-based treatment regimens administered in short courses are preferred over isoniazid monotherapy administered in longer courses for treating LTBI. […] The rifamycin-based preferred regimens for LTBI are as follows: Once-weekly isoniazid plus rifapentine for 3 months (strongly recommended in adults and children 2 years, including those with HIV infection) OR Daily rifampin for 4 months (strongly recommended in HIV-negative adults and children of all ages) OR Daily isoniazid plus rifampin for 3 months (conditionally recommended in adults and children of all ages and HIV-positive persons).

• #2 Tuberculosis (TB) Guidelines: Latent Tuberculosis Infection (LTBI) Treatment Guidelines

  https://emedicine.medscape.com/article/230802-guidelines

  Prescribing providers or pharmacists should note that rifampin and rifapentine are not interchangeable, and care should be taken to administer the correct medication for the intended regimen. […] The alternative treatment regimens are as follows: Daily isoniazid for 6 months (strongly recommended in HIV-negative adults and children of all ages and conditionally in HIV-positive adults and children of all ages) OR Daily isoniazid for 9 months (conditionally recommended in adults and children of all ages regardless of HIV infection status). […] Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC, 2020.

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