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There are two programmatic approaches for Tuberculosis Preventive Therapy (TPT) implementation:

1. Test-and-treat approach – This approach aims to detect TB infection among key groups for implementing TPT.

  • After ruling out active TB, the beneficiary is tested for TB infection.
  • TPT is offered only to those with a positive test (Interferon Gamma Release Assay (IGRA)/ Tuberculin Skin Test (TST)/ Cutaneous TB (C-TB))

2. Treat-only approach – For certain groups, like People Living with HIV (PLHIV) and House Hold Contacts (HHC) < 5 years old, detecting TB infection is not required. Hence, this approach is given.

  •  After ruling out active TB,  TPT is offered without testing for TB infection. 

 

Test and treat approach*

  1. HHC of sputum positive Pulmonary TB >/= 5 years old
  2. Individuals on:
    1. Immunosuppressive therapy
    2. Having silicosis
    3. On anti-TumourTNF treatment
    4. On dialysis
    5. Preparing for solid organ or haematopoietic stem cell transplantation

Treat-only approach

  1. HHC of sputum positive Pulmonary TB (PTB) < 5 years old
  2. PLHIV#

*All efforts should be made to make IGRA available. However, TPT should not be withheld in case of non-availability of IGRA.

#PLHIV < 1 year old are offered TPT only if they are a household contact of an active TB case.

 

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Assessment

Question​

Answer 1​

Answer 2​

Answer 3​

Answer 4​

Correct answer​

Correct explanation​

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Part of Pre-test​

Part of Post-test​

Which of the following category of TPT beneficiaries is offered TPT without IGRA testing?

Household contacts of sputum positive PTB >/= 5 years old

 PLHIV

Patient on dialysis

Silicosis patient

 2

PLHIV and HHC of sputum positive PTB < 5 years old are offered TPT without testing for IGRA. This is called Treat-only approach.

 

Yes

Yes

 

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