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Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

Getahun, H; Matteelli, A; Abubakar, I; Aziz, MA; Baddeley, A; Barreira, D; Den Boon, S; ... Raviglione, M; + view all (2015) Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries. European Respiratory Journal , 46 (6) pp. 1563-1576. 10.1183/13993003.01245-2015. Green open access

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Abstract

Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3–4 month isoniazid plus rifampicin; or 3–4 month rifampicin alone.

Type: Article
Title: Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries
Open access status: An open access version is available from UCL Discovery
DOI: 10.1183/13993003.01245-2015
Publisher version: http://dx.doi.org/10.1183/13993003.01245-2015
Language: English
Additional information: The content of this work is copyright of the authors or their employers. Design and branding are copyright ©ERS 2015. ERJ Open articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0
Keywords: Science & technology, life sciences & biomedicine, respiratory system, cost-effectiveness analysis, multidrug-resistant tuberculosis, randomized controlled-trial, preventive therapy, close contacts, public-health, follow-up, homeless adults, United-States, drug-users.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1479100
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