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Free Content Policies and practices on the programmatic management of LTBI: a survey in the African Region

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BACKGROUND: Although the management of latent tuberculous infection (LTBI) is a core component of the End TB Strategy, there is limited information about the status of implementation of such interventions in most African countries.

METHODS: A web-based survey involving the 47 countries of the African Region was conducted between November 2016 and April 2017.

RESULTS: The questionnaire was completed by 32/47 (68.1%) National TB Programme managers or their delegates. LTBI guidelines were available in four countries (12.5%), while 13 (40.6%) had an LTBI section in their national TB guidelines; there was no significant association with socio-economic conditions and funding allocation. LTBI diagnosis was mostly based on clinical evaluation to rule out active disease, rather than on systematic use of the tuberculin skin test. Respectively 23 (71.8%) and 17 countries (53.1%) reported providing treatment to child contacts aged <5 years and people living with the human immunodeficiency virus (PLHIV). Over two thirds of respondent countries had ongoing activities targeting at least one of the aforementioned high-risk groups. A recording and reporting system for LTBI-related data on child contacts and PLHIV was available in respectively 14 and 12 countries; 7 countries had an LTBI monitoring and evaluation plan.

CONCLUSIONS: These data suggest that greater effort is needed to appropriately scale up LTBI policies in the African Region.
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Keywords: LTBI; TB prevention; high-risk populations; policy; screening

Document Type: Research Article

Affiliations: 1: University Department of Infectious and Tropical Diseases & World Health Organization Collaborating Centre for TB/HIV and TB Elimination University of Brescia, Brescia, Italy;, McGill International TB Centre, McGill University, Montréal, Quebec, Canada 2: Laboratory of Innovation in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Rio de Janeiro, Brazil 3: University Department of Infectious and Tropical Diseases & World Health Organization Collaborating Centre for TB/HIV and TB Elimination University of Brescia, Brescia, Italy; 4: TB/HIV and Community Engagement Unit, Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland

Publication date: 01 February 2018

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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