1. Introduction

The World Health Organization (WHO) has produced this operational handbook on tuberculosis (TB) to provide practical advice to complement the latest WHO consolidated guidelines on tuberculosis, drug-resistant tuberculosis treatment, 2022 update (hereafter referred to as the “WHO consolidated guidelines”). This document provides information on the choice and design of regimens for the treatment of drug-resistant TB (DR-TB), including multidrug- or rifampicin-resistant TB (MDR/RR-TB), and confirmed rifampicin-susceptible, isoniazid-resistant TB (Hr-TB) (1).

The strategies described in this module are mainly based on the latest WHO recommendations (1–3), which were formulated by Guideline Development Groups (GDGs) using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach (4). However, in many cases, the recommendations lacked the level of clinical and programmatic detail needed for implementation. This module complements the guidelines with practical advice based on best practices and knowledge from fields such as pharmacokinetics, pharmacodynamics, microbiology, pharmacovigilance, and clinical and programmatic management.

The practical guidance aims to inform the development or revision of national policies and related implementation guidance (e.g. handbooks, standard operating procedures) on the management of DR-TB.

The chapters of the handbook are aligned with the WHO consolidated guidelines document. The target audience for this handbook include NTPs, other healthcare programmes in public and private sector and technical organizations supporting national programmes.

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