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March 24, 2020 Tuesday 05:15:19 PM IST

WHO Worried Over World's Top Infectious Killer TB

Health Monitor

Tuberculosis (TB) remains the world's most infectious killer, according to World Health Organisation (WHO). March 24 is World TB Day. In 2018 10 mn people fell sick of TB and 1.5 mn died. COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be,“ said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The world committed to end TB by 2030; improving prevention is key to making this happen. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives".
TB preventive treatment has to be intensified and global leaders have committed to giving treatment to 24 million contacts of people with active TB and 6 mn people living with HIV by 2022. To date only a fraction of that target has been reached, with countries putting less than 430,000 contacts and 1.8 million people on TB preventive treatment in 2018.  TB also puts HIV patients at increased chances of mortality.
WHO recommendations
-Scale -up TB preventive treatment among populations at highest risk including household contacts of TB patients, people living with HIV and other people at risk with lowered” immunity or living in crowded settings. 
-integration of TB preventive treatment services into ongoing case finding efforts for active TB. All household contacts of TB patients and people living with HIV are recommended to be screened for active TB. If active TB is ruled out, they should be initiated on TB preventive treatment. 
-Either a tuberculin skin test or interferon-gamma release assay (IGRA) be used to test for TB infection. Both tests are helpful to find people more likely to benefit from TB preventive treatment but should not become a barrier to scale-up access. Testing for TB infection is not required before starting TB preventive treatment in people living with HIV, and children under 5 years who are contacts of people with active TB.
-New shorter options for preventive treatment in addition to the widely used 6 months of daily isoniazid. The shorter options that are now recommended range from a 1-month daily regimen of rifapentine plus isoniazid to 3 months weekly rifapentine plus isoniazid, 3 months daily rifampicin plus isoniazid, or 4 months of daily rifampicin alone.



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