{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:55:56Z","timestamp":1787846156220,"version":"build-2784847793"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,3]],"date-time":"2020-05-03T00:00:00Z","timestamp":1588464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Despite the World Health Organization (WHO)'s updated guidelines on tuberculosis (TB) preventive treatment, the scale\u2010up of TB preventive therapy remains low in many high\u2010burden countries (HBCs). We conducted a survey to better understand the current status of policy implementation and barriers for scale\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2010question 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010seven 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\u2010gamma 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.158","type":"journal-article","created":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T03:24:08Z","timestamp":1588562648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["How are high burden countries implementing policies and tools for latent tuberculosis infection? A survey of current practices and barriers"],"prefix":"10.1002","volume":"3","author":[{"given":"Lena","family":"Faust","sequence":"first","affiliation":[{"name":"McGill International TB Centre Montreal General Hospital  Montreal Quebec Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University  Montreal Qubec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Ruhwald","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics (FIND)  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Schumacher","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics (FIND)  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-4536","authenticated-orcid":false,"given":"Madhukar","family":"Pai","sequence":"additional","affiliation":[{"name":"McGill International TB Centre Montreal General Hospital  Montreal Quebec Canada"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University  Montreal Qubec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,3]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"World Tuberculosis Report","author":"World Health Organization (WHO)","year":"2019"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002152"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l5770"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.17.199414"},{"key":"e_1_2_12_6_1","volume-title":"WHO Consolidated Guidelines on Tuberculosis: Module 1: Tuberculosis Preventive Treatment","author":"World Health Organization (WHO)","year":"2020"},{"key":"e_1_2_12_7_1","unstructured":"General Assembly resolution 73\/3. 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National TB Guidelines 4th ed.; Harare Zimbabwe Ministry of Health and Child Welfare of Zimbabwe;2010.https:\/\/www.who.int\/hiv\/pub\/guidelines\/zimbabwe_tb.pdf. Accessed March 26 2020."},{"key":"e_1_2_12_25_1","volume-title":"National Tuberculosis Control Program: Manual of Procedures","author":"Department of Health, Philippines","year":"2014"},{"key":"e_1_2_12_26_1","volume-title":"Protocolo de vigil\u00e2ncia da infec\u00e7\u00e3o latente pelo Mycobacterium tuberculosis no Brasil","author":"Minist\u00e9rio da sa\u00fade, Brasil","year":"2018"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2019.07.004"},{"key":"e_1_2_12_28_1","unstructured":"Stop TB Partnership. IGRA test for latent TB infection now available through the Stop TB Partnership's Global Drug Facility.2019 Geneva.http:\/\/www.stoptb.org\/news\/stories\/2019\/ns19_030.html. 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