revalence and transmission of TB among people living with HIVA

The guidelines have been developed for a
global audience and it is expected that regions
and countries will adapt the recommendations
to suit their own circumstances. These include
consideration of the epidemiology of TB and HIV,
and defining settings with the highest rates of
prevalence and transmission of TB among people
living with HIV (for example, to implement IPT
lifelong or for 36 months). The ultimate goal of these
adaptations should be to scale up implementation of
services for TB screening, prevention and treatment
as core functions of HIV prevention, treatment and
care services. Depending on the situation of the
country, a national consultation process involving
all the stakeholders should help ensure the creation
of a policy and programme environment that is
conducive to implementation. Critical factors that
need to be addressed during the national adaptation
process include incorporation of TB screening and
IPT as core interventions in the treatment and care
package for people living with HIV. Other critical
functions include the development of standardized
operating procedures, access to INH (preferably
300 mg tablets) for HIV service providers and
implementers, and establishment of an effective
and standardized monitoring and evaluation
(M&E) system. The evaluation of the efficacy of
the guidelines will be done through the global TB
and HIV/AIDS reporting system, which will monitor
country and global implementation of IPT and ICF.
In addition, WHO and ministries of health, along
with key stakeholders, will participate in countrylevel
programme reviews to monitor adaptation and
implementation of the guidelines. Feedback from
the community and other stakeholders will be used
to revise the next edition of the guidelines.