PMID- 32373716
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240328
IS  - 2398-8835 (Electronic)
IS  - 2398-8835 (Linking)
VI  - 3
IP  - 2
DP  - 2020 Jun
TI  - How are high burden countries implementing policies and tools for latent 
      tuberculosis infection? A survey of current practices and barriers.
PG  - e158
LID - 10.1002/hsr2.158 [doi]
LID - e158
AB  - BACKGROUND AND AIMS: Despite the World Health Organization (WHO)'s updated 
      guidelines on tuberculosis (TB) preventive treatment, the scale-up of TB 
      preventive therapy remains low in many high-burden countries (HBCs). We conducted 
      a survey to better understand the current status of policy implementation and 
      barriers for scale-up. METHODS: Survey questions pertained to HBCs' current 
      latent TB infection (LTBI) screening and treatment strategies, and the 
      availability of LTBI tests and newer treatments (eg, isoniazid/rifapentine 
      [3HP]). The 19-question survey was piloted and sent out via email in June 2019 as 
      a protected Microsoft Word document to contacts [National TB Program (NTP) staff, 
      researchers, and health officials] in the 30 TB HBCs. Responses were accepted 
      until February 2020. RESULTS: Thirty-seven completed surveys from 24 HBCs were 
      received. Respondents from five countries (Brazil, Lesotho, Mozambique, Russia, 
      Zambia) reported having LTBI guidelines that are fully implemented. Among 
      respondents who indicated their country currently has no LTBI guideline 
      implementation (Angola, China, DRC, India, Indonesia, Kenya, Myanmar), the most 
      often cited barrier to implementation was the prioritization of active TB over 
      LTBI management (n = 5, Angola, China, DRC, India, Kenya). Of the 16 countries in 
      which respondents reported using purified protein derivative (PPD), 9 reported 
      having experienced a PPD shortage within the past year (from time of survey). 
      Respondents from six countries reported currently using Interferon-gamma Release 
      Assays (IGRAs) in their NTP, and 13 cited high cost as a barrier to IGRA use. 
      Lastly, rifapentine was stated not be available in 8 HBCs. CONCLUSION: This 
      survey indicates limited implementation of WHO LTBI guidelines in HBCs and 
      provides some insight into barriers to implementation, including shortage of 
      products (eg, PPD), high costs (eg, IGRAs), and lack of regulatory approval of 
      newer treatments (eg, rifapentine). Thus, we should work towards price reductions 
      for LTBI tests and treatments, and the development of tests that can be more 
      easily implemented at peripheral healthcare levels.
CI  - (c) 2020 The Authors. Health Science Reports published by Wiley Periodicals LLC.
FAU - Faust, Lena
AU  - Faust L
AD  - McGill International TB Centre Montreal General Hospital Montreal Quebec Canada.
AD  - Department of Epidemiology, Biostatistics and Occupational Health McGill 
      University Montreal Qubec Canada.
FAU - Ruhwald, Morten
AU  - Ruhwald M
AD  - Foundation for Innovative New Diagnostics (FIND) Geneva Switzerland.
FAU - Schumacher, Samuel
AU  - Schumacher S
AD  - Foundation for Innovative New Diagnostics (FIND) Geneva Switzerland.
FAU - Pai, Madhukar
AU  - Pai M
AUID- ORCID: 0000-0003-3667-4536
AD  - McGill International TB Centre Montreal General Hospital Montreal Quebec Canada.
AD  - Department of Epidemiology, Biostatistics and Occupational Health McGill 
      University Montreal Qubec Canada.
LA  - eng
PT  - Journal Article
DEP - 20200503
PL  - United States
TA  - Health Sci Rep
JT  - Health science reports
JID - 101728855
PMC - PMC7196590
OTO - NOTNLM
OT  - latent tuberculosis
OT  - purified protein derivative
OT  - rifapentine
OT  - screening
COIS- L. F. has no competing interests to disclose. M. R. and S. S. are employed at 
      FIND, a not-for-profit foundation evaluating diagnostics for TB and other 
      diseases, with FIND's neutrality regarding these evaluations clearly established 
      in product evaluation agreements. M. P. has previously served as a consultant for 
      the Bill & Melinda Gates Foundation, and serves on FIND's Scientific Advisory 
      Committee. These conflicts did not affect the study design, analysis, or 
      interpretation.
EDAT- 2020/05/07 06:00
MHDA- 2020/05/07 06:01
PMCR- 2020/05/03
CRDT- 2020/05/07 06:00
PHST- 2020/02/02 00:00 [received]
PHST- 2020/03/26 00:00 [revised]
PHST- 2020/03/30 00:00 [accepted]
PHST- 2020/05/07 06:00 [entrez]
PHST- 2020/05/07 06:00 [pubmed]
PHST- 2020/05/07 06:01 [medline]
PHST- 2020/05/03 00:00 [pmc-release]
AID - HSR2158 [pii]
AID - 10.1002/hsr2.158 [doi]
PST - epublish
SO  - Health Sci Rep. 2020 May 3;3(2):e158. doi: 10.1002/hsr2.158. eCollection 2020 
      Jun.