TPT_2.6_Rationale_VideoLecture_PPT_Final.pdf
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The document outlines the cascade of care for tuberculosis (TB) preventive treatment (TPT). It describes the steps along the cascade as reaching at-risk individuals, preparing for TPT by excluding active TB, and providing TPT with adherence support and monitoring. It emphasizes that TPT programmes should be people-centered and provide support along the entire cascade of care, from screening to treatment completion while also addressing common misconceptions about TPT.
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- 1. 2.6 Cascade of care for TB preventive treatment
- 2. Overview • Cascade of care for TB preventive treatment (TPT) • Steps along the cascade of care • Addressing common misconceptions • Active TB case-finding and TPT
- 3. Cascade of care for TPT A conceptual approach to organizing TPT activities People-centred focus
- 4. Active TB case-finding and TPT Target population TB screening Presumptive TB Test for TB disease TB confirmed Provide TB treatment No TB Systematic follow-up and support to individuals on treatment for TB disease or infection No TB Test for TB infection Assess for TPT Give TPT No TB and living with HIV or household TB contact < 5 years or test not available Link: Guidelines Link: Operational handbook
- 5. Steps along the cascade of care Reaching at-risk individuals Preparing for TPT Providing TPT Target population Identify individuals Exclude TB (+/- chest X- ray) Baseline evaluation Initiate TPT Adherence support and monitoring Treatment completion
- 6. • HIV clinics • TB contact evaluation • General health facilities • Congregate settings Reaching at-risk individuals Reaching at-risk individuals Determine target population • People living with HIV • TB contacts • Clinical risk groups • Other high-risk groups Identify individuals
- 7. • Contraindications • Comorbidities • Drug–drug interactions Preparing for TB preventive treatment Preparing for TPT Exclude TB (+/- chest X-ray) • Symptom screening • Clinical evaluation • Access to chest X-ray and TB diagnostic tests Baseline evaluation
- 8. • Assess treatment completion • Document treatment outcomes Providing TB preventive treatment Providing TPT Initiate TPT • TPT regimen • Assess risk and side-effects • Counselling Adherence support and monitoring Treatment completion • Monitoring visits • Supplies of drugs • Community health-care worker involvement Recording and reporting
- 9. Facts vs misconceptions about TPT TPT • rarely causes severe adverse drug reactions • need not be directly observed treatment • provides 60–90% protection • does not create drug resistance • has a lasting protective effect High-priority groups can be prescribed TPT without a positive test for TB infection
- 10. Summary TPT services should Programmes should be linked with active TB case- finding strategies be people- centred provide support along the cascade of care address misconceptions