Meeting report of the WHO expert consultation on drug-resistant tuberculosis treatment outcome definitions, 17–19 November 2020


Book Description

Recent developments in TB treatment have prompted the need for revision of the TB treatment outcome definitions. An online expert consultation meeting organized by WHO’s Global TB Programme in November 2020 was to determine recent changes in TB treatment affecting treatment outcome definitions and discuss options for changing the definitions. The consultation led WHO to propose new treatment outcome definitions for drug-susceptible TB (DS-TB) and drug-resistant TB (DR-TB). The purpose of this publication is to summarise changes in the definitions of tuberculosis treatment outcomes, arising after the expert consultation. The publication is to inform a wide audience about the new definitions of TB treatment outcomes so that these definitions are readily adopted and used, globally.







WHO consolidated guidelines on tuberculosis. Module 4


Book Description

Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.




WHO consolidated guidelines on tuberculosis. Module 5


Book Description

The objectives of the 2022 consolidated guidelines are: to provide policy makers and implementing partners with evidence-based recommendations on the cascade of care for children and adolescents; to support the implementation of activities to prevent TB among children and adolescents at risk; to improve TB case detection and treatment outcomes in children and adolescents with TB using effective models of care; and to contribute to reductions in TB related morbidity and mortality in children and adolescents in line with global targets including those in the UN Sustainable Development Goals, the WHO End TB Strategy and the Political Declaration of the United Nations General Assembly High-Level Meeting on the Fight against Tuberculosis. The target audience for these consolidated guidelines consists primarily of national TB programmes (NTPs), primary health care (PHC) programmes, maternal and child health programmes, national AIDS programmes (or their equivalents in health ministries) and other health policy makers. They also target generalist and specialist paediatricians, clinicians and health practitioners working on TB, HIV and/or infectious diseases in public and private sectors, the educational sector, nongovernmental-, civil society- and community-based organizations, as well as technical and implementing partners.




Target product profile for next-generation drug-susceptibility testing at peripheral centres


Book Description

The first high-priority Target Product Profile (TPPs) for new tuberculosis diagnostics were launched in April 2014. Following advances in the TB diagnostics and treatment pipelines since the release of these TPPs as well as recent updates to WHO TB treatment and diagnostics guidelines, a revision process of this TPP was initiated. The objective of the revision was to steer the R&D pipeline discussions to address current diagnostic gaps, seeking alignment with and patient and population needs.




WHO operational handbook on tuberculosis. Module 4


Book Description

Operational handbook on tuberculosis. Module 4: Treatment of drug-resistant tuberculosis treatment, is a derivative product arising from the guideline on the same topic. This operational handbook is designed to facilitate implementation of the policy at country level. The target audience includes, implementing partners, programme managers, clinicians and other stakeholders engaged in TB care. The 2022 updated version of the operational handbook includes a new section stemming from the most recent round of guidelines development – the recommendation for 6-month regimen, and a new composition of the 9-month regimen for the treatment of DR-TB. Besides, the updated operational handbook includes three new web annexes: Tuberculosis medicines information sheets, management of adverse events and Active TB drug safety monitoring and management (aDSM).







WHO consolidated guidelines on drug-resistant tuberculosis treatment


Book Description

Tuberculosis (TB) strains with drug resistance (DR-TB) are more difficult to treat than drug-susceptible ones, and threaten global progress towards the targets set by the End TB Strategy of the World Health Organization (WHO). There is thus a critical need for evidence-based policy recommendations on the treatment and care of patients with DR-TB, based on the most recent and comprehensive evidence available. In this regard, the WHO consolidated guidelines on drug-resistant tuberculosis treatment fulfil the mandate of WHO to inform health professionals in Member States on how to improve treatment and care for patients with DR-TB. Between 2011 and 2018, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO treatment guidelines for multidrug- and rifampicin-resistant tuberculosis, 2018 update, issued by WHO in December 2018. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups (GDGs), using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present Consolidated guidelines include a comprehensive set of WHO recommendations for the treatment and care of DR-TB, derived from these WHO guidelines documents. The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, including longer and shorter regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.