low

Health workers may gain additional protection from TB through the use of particulate respirators that meet or exceed the
N95 standards set by the United States Centers for Disease Control and Prevention/National Institute for Occupational
Safety and Health (CDC/NIOSH) or the FFP2 standards that are CE certified (see rest of recommendation p. 15 of guideline).

Prompt identification of people with TB symptoms (i.e. triage) is crucial. The specific criteria for triaging patients will depend
on the local settings and patient population. However, in general, people suspected of having TB must be separated from
other patients, placed in adequately ventilated areas, educated on cough etiquette and respiratory hygiene, and be diagnosed as a matter of priority (i.e. fast tracked).

In adults and children with signs and symptoms of extrapulmonary TB, Xpert Ultra may be used in lymph node aspirate and lymph node biopsy as the initial diagnostic test for lymph nodes TB rather than smear microscopy/culture.

In adults with signs and symptoms of pulmonary TB and with a prior history of TB and an end of treatment within the last 5 years, Xpert Ultra may be used as an initial diagnostic test for TB and for rifampicin-resistance detection in sputum, rather than smear microscopy/culture and phenotypic DST.

WHO suggests 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) or seriously ill.

A package of treatment adherence interventions may be offered to patients on TB treatment
in conjunction with the selection of a suitable treatment administration option.

Clavulanic acid should not be included in the treatment of MDR/RR-TB patients on longer
regimens.

Respiratory hygiene (including cough etiquette)
in people with presumed or confirmed TB
is 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.

Healthcare facility level: The panel recommends that regular monitoring/audit and timely feedback of healthcare practices,
according to IPC standards, should be performed to prevent and control HAIs and AMR at the
healthcare facility level. Feedback should be provided to all audited persons and relevant staff.

National level: The panel recommends that national IPC programmes should coordinate and facilitate the
implementation of IPC activities through multimodal strategies on a nationwide or subnational level.