Intensifying action against latent tuberculosis infection
If 8% of persons with latent tuberculosis could be permanently protected each year, the global TB incidence in 2050 would be 14 times lower as the incidence in 2013, with no other intervention needed.
On 28 May 2015 the NEJM published an article by authors from the Global TB Programme of WHO and Johns Hopkins University on latent tuberculosis (TB) infection, the management of which constitutes an important component of the End TB Strategy. Although the vast majority of persons latently infected by tuberculosis have no signs or symptoms of TB disease and are not infectious, they are at risk of developing active TB disease during their lifetime.
“Management of latent tuberculosis in population groups at high risk of developing TB particularly in countries with low incidence of TB is a fundamental intervention for elimination of tuberculosis,” said Dr Mario Raviglione, Director of the Global TB Programme of WHO and one of the authors of the paper. “It is time to intensify our actions against latent tuberculosis infection,” he added. The paper reported that if 8% of persons with latent tuberculosis could be permanently protected each year, the global incidence in 2050 would be 14 times lower as the incidence in 2013, with no other intervention needed. The paper summarises the pathogenesis, epidemiology, diagnosis, and treatment of latent tuberculosis infection and addressed critical gaps in the understanding of this complex condition propsing the necessary research agenda.
The paper particularly highlighted the huge potential that a new test or treatment for this public health problem would generate, including in market terms. Such potential about latent TB infection, which is estimated to affect one third of the world population, should motivate the corporate sector to invest in research. The article therefore also calls for the reassessment of the global burden and a better understanding of the magnitude of latent tuberculosis infection to inform both clinical and public health measures. “Intensifying research efforts and cooperation across disciplines including novel public-corporate partnerships are critical to fully address the risk of latent TB” said Dr Haileyesus Getahun, who is the lead author of the paper and coordinator of the team working on latent TB at the Global TB Programme in WHO. This publication comes at the time when WHO recognizes the management of latent tuberculosis infection as an essential element in the implementation of the END-TB strategy and the TB elimination framework in low incidence countries. In early 2015 WHO issued the ‘Guidelines on the management of latent tuberculosis infection’ (http://www.who.int/tb/publications/latent-tuberculosis-infection/en/) which provides recommendations for a public health approach to implement evidence-based practices for testing and treating latent TB in low TB incidence countries. It also recently established a Global Task Force to get expert advice on how to scale-up detection and treatment of latent infection. The Task Force is composed of 31 members coming from over 25 different countries, selected on the basis of their technical skills and expertise in latent TB programmatic management, research and development.
