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Guideline: Nutritional care and support for patients with tuberculosis
Maria del Carmen Casanovas, Knut Lönnroth, Luz Maria De-Regil et al
World Health Organization
(2013)
C_WHO
Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that under
...
nutrition is a risk factor for progression from TB infection to active TB disease and that undernutrition at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
more
WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment
The 2020 recommendations for the programmatic management of TB preventive treatment are the first to be released under the rubric of WHO consolidated TB guidelines (Module 1 – Prevention). The WHO
...
consolidated TB guidelines will gradually group all TB recommendations and will be complemented by matching modules of a consolidated operational handbook. [1] The handbook will provide practical advice on how to put in place the recommendations at the scale needed to achieve national and global impact. The first handbook module in the series will be on the programmatic management of TB preventive treatment and will accompany the 2020 guidelines.
more
Previous advocacy efforts have achieved tangible goals in terms garnering political commitments
to increase financing for TB—as seen at the 2018 UN High-Level Meeting on TB. The challenge
now is to ensure that these commitments are actually met within a global biomedical research
ecosystem that
...
is designed and incentivized to prioritize the health needs of wealthy populations
more
This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact
...
of COVID-19 on essential services. This is followed by key figures for the region, the role of WHO in country support and, recognizing the importance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
more
People affected by impairments and disabilities associated with TB are even more likely to belong to marginalized segments of society and are more likely to have their human rights unprotected. The challenges faced by people affected by TB include t
...
he consequences of impairment and disability associated with the disease, its treatment as well as with the stigma and discrimination applied to people affected by TB. There is now compelling evidence that the disease and its treatment affect quality of life and life expectancy even after successful treatment.
The WHO Global Tuberculosis Programme has produced the first policy brief on TB-associated disability, building on the increasing evidence in recent years on the unaddressed needs of people with TB who experience impairment and disability while on TB treatment and after completing TB treatment.
more
The WHO Global tuberculosis report 2024 provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagn
...
osis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
more
Global tuberculosis report 2022
recommended
The WHO Global Tuberculosis Report 2022 provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagn
...
osis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
The 2022 edition of the report is as usual, based primarily on data gathered by WHO from national ministries of health in annual rounds of data collection. In 2022, 202 countries and territories with more than 99% of the world’s population and TB cases reported data
more
This analytical report reviews and discusses the potential role and influence of political commitment in implementing endorsements and conducting policy in the field of
...
tuberculosis (TB) prevention and care. It promotes discussion by comparing and analysing the extent to which selected international commitments, set out in declarations and other committal documents between 2000 and 2018, may have translated into sustainable action. This reflection is relevant and timely, as the United Nations high-level meeting (UNHLM) on TB recently took place, offering countries the opportunity to take stock of progress made, refocus efforts, and step up global commitments to achieve the United Nations Sustainable Development Goal of eliminating TB by 2030
more
People living with HIV who have a low CD4 count are at a much higher risk of falling ill from TB infection than HIV negative people.
It is important to offer both HIV testing to TB patients and TB diagnosis in HIV patients. Early detection and
...
effective treatment are essential to preventing TB-associated deaths.
WHO and UNAIDS have strongly advised countries to ensure that HIV programmes integrate regular TB screening, preventive therapy and early treatment.
more
The Global Strategy for Tuberculosis Research and Innovation will support the efforts of governments and other stakeholders to accelerate TB research and innovation, and improve equitable access to
...
the benefits of research.
Availabl in Arabic, Chinese, English, French, Spanish and Russian
more
13 May 2021
To avoid a reversal of progress from the adverse impacts of the COVID-19 pandemic, new knowledge and lessons from successful programmatic innovations are urgently needed to improve TB p
...
revention and care. Experience can provide evidence for innovative approaches and strategies to maintain and scale up high-quality TB services. WHO therefore called for case studies on programmatic innovations that address emerging challenges in TB prevention and care during the pandemic in order to collect and disseminate the findings to the TB community. Between November 2020 and February 2021, a total of 23 case studies relevant to the call were accepted from 19 countries in the six regions of WHO. The lessons learnt from these country activities to ensure the continuity of essential services like TB care in the face of the crippling crisis may also inform strategies for minimizing the impact of future emerging pathogens on health services.
more
7 April 2022. Aimed at national policymakers, public health and healthcare planners, staff working in reception centres, and healthcare staff caring for displaced persons, the information note concludes that universal testing of incoming refugees fr
...
om Ukraine for tuberculosis (TB) infection is not recommended. Specific groups, such as household contacts of bacteriologically confirmed pulmonary cases, or those who are immunocompromised should however be considered for TB infection testing.
Available in Czech, Hungarian, Polish, Romanian, Slovakian, Ukranian
more
This guidance is intended for use in developing standalone TB strategic plans, or TB interventions as part of multidisease or health sector plans. It describes key considerations and steps for strategic planning for TB in line with the World Health
...
Organization’s End TB strategy, and the proposed structure of the NSP. The target audience of this publication are all stakeholders involved in national strategic planning for TB (e.g., ministry of health, other government ministries, private sector, civil society, affected communities, academic and research institutions, and technical and funding partners).
The current document is an update to the 2015 Toolkit to develop a national strategic plan for TB prevention, care and control.
more
This report presents three scenarios on the impact of COVID-19 in Africa using economic growth forecasts, mortality and efforts to ameliorate impact through social grants. Likely effects are examine
...
d on per capita income, poverty and the attainment of selected Sustainable Development Goals targets. Africa’s development trajectory has suffered a severe setback, with extreme poverty rising in all the scenarios. The pandemic threatens Africa in several ways, and the report provides policy recommendations to reduce vulnerability and strengthen resilience.
more
Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB
...
and comorbidities. The Framework for collaborative action on TB and comorbidities aims to support countries in the evidence-informed introduction and scale-up of holistic people-centred services for TB, comorbidities and health-related risk factors, with the goal of comprehensively addressing TB and other co-existing health conditions. It should be used in conjunction with relevant WHO guidelines. The Framework is intended for use by people working in ministries of health, other relevant line-ministries, policymakers, international technical and funding organizations, researchers, nongovernmental and civil society organizations, as well as primary care workers, specialist health practitioners, and community health workers who support the response to TB and comorbidities in both the public and private sectors.
more
The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version
...
of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the latest practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate
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, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Though there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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The “United Nations Framework for the immediate socio-economic response to COVID-19: Shared responsibility, global solidarity and urgent action for people in need” calls for protecting jobs, businesses and livelihoods to set in motion a safe rec
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overy of societies and economies as soon as possible for a more sustainable, gender-equal, and carbon-neutral path—better than the “old normal”.
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This Framework offers a coherent approach for eliminating tuberculosis (TB) in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of
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the national TB response in accelerating efforts towards elimination. The document will also be informative for public health surveillance officers, practitioners and nongovernmental and civil society partners working on natioal TB care and prevention and serving the populations most vulnerable to TB.
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