Scope of the guidelines

These updated guidelines focus on a package of interventions aimed at reducing the risk of M. tuberculosis transmission, and they supersede the 2009 recommendations (7). Overall, the recommendations cover health care and other groups outside the health care system; also, where possible, specific remarks and additional considerations are given, to highlight specific areas or processes required for the implementation of these recommendations within health care facilities and other, non-health care settings such as congregate settings, community settings and households.

These guidelines do not present interventions directed to household settings, given that there was no directly applicable evidence that fulfilled the inclusion criteria for this systematic evaluation of data. However, some considerations pertinent to households are mentioned, where applicable (i.e. respiratory hygiene and respiratory protection) under implementation considerations. Similarly, these guidelines do not cover any aspects related to TB laboratory biosafety because this area of work is addressed elsewhere (14, 15).Another strategy that is critical for reducing the burden of TB disease among individuals exposed to M. tuberculosis – preventive treatment – is further described in the 2018 updated and consolidated guidelines for programmatic management of latent TB infection (LTBI) (16).

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