Tuberculosis (TB) has been around for centuries and is still a major health challenge. TB typically affects the lungs but sometimes other parts of the body such as the kidneys, spine, and brain. It is most prevalent in developing countries but remains a significant health problem even in developed countries. The fight against TB, known as “End TB”, is also very much threatened by multidrug resistance.

Another major priority to End TB is “Latent TB infection” (LTBI). LTBI is a state of persistent immune response to the bacteria causing TB but without clinically active TB disease. The global burden of LTBI is estimated to be up to 1/3 of the world population! This is an essential issue because it represents a significant reservoir of future active TB. There is a 5-10% lifetime risk of progressing from LTBI to active TB disease. Preventing active TB by treating LTBI is a critical component of the WHO End TB Strategy.

Characterizing the epidemiology of TB and/or LTBI in a community is essential to develop effective strategies for the prevention and control of the disease.

Tuberculosis

Burden and Challenges

Tuberculosis Consultancies

Surveys and Interventions

The Implementation of “universal TB guidelines” has been challenging. The probability of progression in specific risk groups, TB epidemiology, resource availability, and the potential public health impact are important parameters to account for. Depending on local characteristics and expected health outcomes, different surveys or studies could be used to assess the burden of active TB or LTBI in a community. Below are a few examples of consultancies that could be adapted for both TB and LTBI in the community you wish to support.

Cross-sectional surveys: Cross-sectional surveys are often used to estimate the prevalence of TB or LTBI in a community. This study design involves the collection of data from a representative sample of individuals at a specific point in time.

Case-control studies: Case-control studies are used to identify risk factors for tuberculosis by comparing individuals with and without tuberculosis. In this study design, cases (individuals with tuberculosis) are matched with controls (individuals without tuberculosis) based on demographic characteristics.

Ecological studies: Ecological studies are used to examine the association between tuberculosis and environmental factors, such as poverty, air pollution, and population density. This study design can provide information on the contextual factors that contribute to tuberculosis transmission and prevalence.

Intervention Trials: involve implementing and testing interventions at the community level to prevent TB transmission, improve case detection, ensure treatment adherence, or enhance other aspects of TB control. Depending on local epidemiology and priorities, interventions can be “Community-Based Active Case Finding”, “Contact Tracing and Preventive Therapy for LTBI”, “Behavioral Interventions”, or “Community-Based MDR-TB Management”.

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