Reducing tuberculosis transmission: a consensus document from the World Health Organization Regional Office for Europe

Abstract

Evidence-based guidance is needed on 1) how tuberculosis (TB) infectiousness evolves in response to effective treatment and 2) how the TB infection risk can be minimised to help countries to implement community-based, outpatient-based care.This document aims to 1) review the available evidence on how quickly TB infectiousness responds to effective treatment (and which factors can lower or boost infectiousness), 2) review policy options on the infectiousness of TB patients relevant to the World Health Organization European Region, 3) define limitations of the available evidence and 4) provide recommendations for further research.The consensus document aims to target all professionals dealing with TB (e.g. TB specialists, pulmonologists, infectious disease specialists, primary healthcare professionals, and other clinical and public health professionals), as well as health staff working in settings where TB infection is prevalent.

Cost-effectiveness of IGRA/QFT-Plus for TB screening of migrants in Oman

“…A recent review of treatment of LTBI in migrants found that overall poor compliance was key to poor performance (Greenaway et al, 2018). This is also emphasized in the analysis presented in the present study, which clearly demonstrated that cost-effectiveness depends on good compliance; community support is needed to increase compliance (Migliori et al, 2019).…”

Universal use of face masks for success against COVID-19: evidence and implications for prevention policies

“…It is well known that surgical masks can prevent the inhalation of large droplets and sprays but have limited ability to filter submicron-sized airborne particles [8,9]. As SARS-CoV-2 is also embedded in aerosols <5 μm in diameter, it cannot be determined whether they are always effective.…”

“…As SARS-CoV-2 is also embedded in aerosols <5 μm in diameter, it cannot be determined whether they are always effective. However, mask wearing by patients with pulmonary tuberculosis (an airborne infectious disease) has been shown to reduce infectivity to guinea pigs by 56% [9,10]. The surgical mask has also been shown to intercept other human coronaviruses during coughing [11].…”

Celebrating World Tuberculosis Day at the time of COVID-19

“…A second similarity is the importance of timely and rapid diagnosis and public awareness for infectious disease control. Long-standing struggles in TB diagnosis represent one of the main reasons for on-going disease transmission in many settings [6,7]. Recent clusters of MDR-TB in Italy and Europe have been linked to diagnostic delays together with inappropriate treatment [8], mainly attributed to the lack of expertise and clinical suspicion on a disease perceived as disappeared.…”