Posted: April 29th, 2024

Assessing provider adherence to guidelines for screening and treatment of latent tuberculosis infection

Assessing provider adherence to guidelines for screening and treatment of latent tuberculosis infection
Latent tuberculosis infection (LTBI) is a condition in which a person is infected with Mycobacterium tuberculosis, the bacterium that causes tuberculosis (TB), but does not have active disease. LTBI is a major risk factor for developing active TB, especially in people with weakened immune systems. Therefore, screening and treatment of LTBI are important strategies to prevent TB and reduce its transmission.

According to the World Health Organization (WHO), an estimated 1.7 billion people, or 23% of the global population, have LTBI. However, only a small fraction of them are diagnosed and treated. The WHO recommends that high-risk groups, such as people living with HIV, household contacts of TB patients, and health care workers, should be systematically screened for LTBI and offered preventive treatment if eligible. The WHO also provides guidelines on how to select the most appropriate screening and treatment regimens based on the local epidemiology, resources, and preferences.

However, the implementation of these guidelines varies widely across different settings and countries. There are many barriers and challenges that affect the adherence of health care providers to the recommended practices for LTBI screening and treatment. Some of these include:

– Lack of awareness and knowledge of the guidelines among health care providers and patients
– Low availability and accessibility of diagnostic tests and drugs for LTBI
– High costs and logistical difficulties of screening and treatment programs
– Low acceptance and adherence of preventive treatment by patients due to long duration, side effects, and stigma
– Poor monitoring and evaluation of LTBI screening and treatment outcomes
– Lack of coordination and collaboration among different stakeholders involved in LTBI care

Therefore, there is a need to assess the current situation of provider adherence to the WHO guidelines for LTBI screening and treatment in different settings and identify the factors that influence it. This would help to design and implement effective interventions to improve the quality of LTBI care and prevent TB.

References:

– World Health Organization. (2018). Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization.
– Getahun, H., Matteelli, A., Abubakar, I., & Aziz, M. A. (2015). Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries. European Respiratory Journal, 46(6), 1563-1576.
– Fox, G. J., Barry, S. E., Britton, W. J., & Marks, G. B. (2013). Contact investigation for tuberculosis: a systematic review and meta-analysis. European Respiratory Journal, 41(1), 140-156.
– Dorman, S. E., Belknap, R., Graviss, E. A., Reves, R., Schluger, N., Weinfurter, P., … & Nahid, P. (2015). Interferon-γ release assays and tuberculin skin testing for diagnosis of latent tuberculosis infection in healthcare workers in the United States. American Journal of Respiratory and Critical Care Medicine, 191(4), 489-497.

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