2. Rationale

WHO guidelines on PMTPT are premised upon the probability that the condition will progress to active TB disease in specific risk groups, on the underlying epidemiology and burden of TB, the feasibility of the intervention, and the likelihood of a broader public health impact. They are expected to provide the basis for the development of national guidelines for LTBI management, adapted to the local circumstances. Although these revised guidelines envisage a massive expansion in population level treatment of LTBI, global coverage of the intervention is still very low even in the priority target groups (10). The Latent TB Infection : Updated and consolidated guidelines for programmatic management released by WHO in 2018 brought together recommendations previously dispersed in several other guidelines to facilitate access to the most recent policies that are still valid for PLHIV (11), for children under 5 years who are household contacts of people with pulmonary TB (12), for other contacts of people with TB, and for clinical risk groups (13),(14),(15),(16). In addition, the 2018 guidelines updated 7 previous recommendations and included 7 new ones. Since the publication of these guidelines in early 2018 new evidence became available that made it necessary to revisit some of the recommendations once more.

³ Given that the main difference from active TB is the absence of disease and given that infection cannot always be considered latent, the condition is sometimes referred to as TB infection (TBI).

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