Consolidated Guidelines

1. Global tuberculosis report 2018 (WHO/ CDS/TB/2018.20). Geneva: World Health Organization; 2018 (http://apps.who.int/iris/bitstream/handle/10665/274453/9789241565646-eng. pdf?ua=1, accessed 18 December 2018).

These guidelines will be available online and will be supported by peer-reviewed publication of the process and the systematic reviews on which these recommendations are based.

During the guideline development process, the Guideline Development Group identified important knowledge gaps that need to be closed through both primary and secondary research in order to better inform the adoption of current IPC practices and, potentially, of new practices.

The general research gaps listed below are to be prioritized for all IPC interventions:

Following the in-person meeting, the responsible technical officer from the WHO Steering Group prepared a draft of the full guideline document, to accurately reflect the deliberations and decisions made by members of the Guideline Development Group. The document was revised based on the feedback received from this group and was later sent to members of the External Review Group for peer-review.

All policy recommendations should ideally be formulated through a consensus process based on the judgements of the Guideline Development Group, informed by the evidence (especially certainty or uncertainty about the benefit–harm balance) and by the expertise and experience of the group members. In the development of these guidelines there were occasions where consensus was not reached, and members of the Guideline Development Group resorted to a voting process.

GRADE evidence-to-decision frameworks were developed through the GRADEpro Guideline Development Tool (GDT) software to support the process of moving from evidence to decisions, help Guideline Development Groups structure their discussions, and make the process and the basis for decisions objective and transparent.

Systematic review teams at the London School of Hygiene & Tropical Medicine and the University of Sydney were asked to prepare standard protocols before embarking on the review. These protocols were then evaluated and endorsed by the Guideline Steering Group and the guideline development methodologist. Seven systematic reviews were conducted to inform the development of these guidelines.

The process of development of these guidelines followed the WHO handbook for guideline development (73). In summary, the process included identifying priority questions and outcomes, retrieving the evidence, assessing and synthesizing the evidence, formulating the recommendations, and planning for dissemination and implementation. The process also required the establishment of the following bodies: a WHO Steering Group, a Guideline Development Group and an External Review Group.

The threats posed by epidemics, pandemics and AMR have become increasingly evident as ongoing universal challenges, and they are now recognized as a top priority for action on the global health agenda. Effective IPC is the cornerstone of such action. The International health regulations position effective IPC as a key strategy for dealing with public health threats of international concern (70).

Respiratory protection controls are designed to further reduce the risk of exposure to M. tuberculosis (and other airborne pathogens) for health workers in special areas and circumstances. The recommendations given here are aimed at strengthening these controls, and preventing the inadequate implementation of respiratory protection programmes that may lead to a false sense of security and therefore increase the risk to health care staff.