moderate

WHO strongly recommends using LF-LAM to assist in the diagnosis of active TB in HIV-positive adults, adolescents and children
with signs and symptoms of TB (pulmonary and/or extrapulmonary).

For persons with a sputum smear-positive specimen or a cultured isolate of MTBC, commercial molecular LPAs may be used as the initial test instead of phenotypic culture-based DST to detect resistance to rifampicin and isoniazid.

In adults and children with signs and symptoms of pulmonary TB, the Truenat MTB or MTB Plus may be used as an initial diagnostic test for TB rather than smear microscopy/culture.

Linezolid should be included in the treatment of MDR/RR-TB patients on longer regimens.

Levofloxacin or moxifloxacin should be included in the treatment of MDR/RR-TB patients on
longer regimens.

Health education and counselling on the disease and treatment adherence should
be provided to patients on tuberculosis (TB) treatment.

In multidrug- or rifampicin-resistant tuberculosis (MDR/RR-TB) patients on longer regimens, the performance of sputum culture in addition to sputum smear microscopy is recommended to monitor treatment response. It is desirable for sputum culture to be repeated at monthly intervals.

Delamanid may be included in the treatment of MDR/RR-TB patients aged 3 years or more on
longer regimens.

Upper-room germicidal ultraviolet (GUV)
systems are recommended to reduce
M. tuberculosis transmission to health
workers, persons attending health care
facilities or other persons in settings with a
high risk of transmission.

National level: The panel recommends that a national IPC monitoring and evaluation programme should be
established to assess the extent to which standards are being met and activities are being
performed, according to the programme’s goals and objectives. Hand hygiene monitoring
with feedback should be considered as a key performance indicator at the national level.