About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s immunological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance.

The 2024 recommendations for the programmatic management of TPT are released as part of Module 1 of the WHO consolidated TB guidelines series. The guidelines are complemented by an operational handbook, that provides practical advice on how to implement the recommendations at the scale needed to achieve national and global impact. The guidelines and the handbook are the second edition of the documents and update the edition that was first published in 2020.

The 21 recommendations contained in the second edition of the guidelines cover critical steps in programmatic management of TPT. The main changes from the first edition of the guidelines include a new, strong recommendation on TPT for contacts of multidrug- or rifampicin-resistant TB (MDR/RR-TB); the integration of recommendations from the 2021 WHO TB screening guidelines and the 2022 WHO guidelines on testing of TB infection; withdrawal of two older recommendations that presented issues to implementation; revisions to the wording of recommendations to align with current terminology; and updates to the research gaps and references.

The operational limitations that need to be overcome by countries to achieve global targets are highlighted and discussed in greater detail in the accompanying operational handbook that is being released concurrently. The guidelines and handbook are to be used primarily in national TB and HIV programmes, or their equivalents in ministries of health, and for other policy-makers working on TB, HIV and infectious diseases in public and private sectors and in the community.

据估计，世界上约有四分之一的人口感染过结核杆菌，其中约5-10%的感染者在其一生中患上结核病。感染后结核病的风险取决于几个因素，最重要的是人的免疫状态。正如2023年第二次联合国结核病问题高级别会议所重申的那样，向从结核病感染发展为疾病的最高风险人群提供结核病预防治疗仍然是实现《终止结核病战略》全球目标的关键因素。有效和安全地提供TPT，需要采取一种规划方法，在一系列护理中实施一揽子综合干预措施：确定风险最高的个体，筛查结核病并排除结核病，检测结核病感染，选择最适合个人的预防性治疗方案，管理不良事件，支持药物依从性和监测规划绩效。

2024年TPT规划管理建议作为世卫组织结核综合指南系列模块1的一部分发布。指导方针还附有一本业务手册，就如何在实现国家和全球影响所需的规模上执行建议提供了实际咨询意见。该指南和手册是该文件的第二版，是对2020年第一版的更新。

准则第二版所载的21项建议涵盖了技术培训方案管理的关键步骤。与第一版指南相比，主要变化包括对耐多药或利福平结核接触者采用TPT的新强烈建议；整合2021年世卫组织结核病筛查指南和2022年世卫组织结核病感染检测指南的建议；撤回对执行提出问题的两项旧建议；修订建议的措辞，使其与现行术语保持一致；更新研究空白和参考文献。

同时印发的随附业务手册强调和更详细地讨论了各国为实现全球目标需要克服的业务限制。这些指南和手册将主要用于国家结核病和艾滋病毒规划，或卫生部的相应规划，以及公共和私营部门以及社区中从事结核病、艾滋病毒和传染病工作的其他决策者。