TB Preventive Treatment [TPT]: Treatment Adherence for Contacts of DR-TB Index Patients

Adherence to the Tuberculosis Preventive Treatment (TPT) course and treatment completion are important determinants of clinical benefit, both at individual and population levels.

• Develop a personal adherence plan with the support of the family member, caregiver or health worker as per the treatment regimen being provided.
• Treatment support and adherence monitoring will be like that of the index patient. 
• Give first preference to the family member to be the treatment provider in consultation with the person. 
• Use of digital platforms (tele/ video calls, 99DOTS/ MERM), counting empty blisters, refill monitoring etc., to strengthen adherence monitoring. 
• Irregular or inadequate treatment reduces the protective efficacy of TPT regimen.
• Poor adherence or early cessation of TPT can potentially increase the risk of the individual developing TB including Drug-resistant Tuberculosis (DR-TB) (although not supported by existing evidence from research settings).
• It is known that the efficacy of TPT is greatest if at least 80% of the doses are taken within the duration of the regimen. The total number of doses taken is also a key determinant of the extent of TB prevention. 

The criteria for completion of TPT among DR-TB contacts have been given in the table below.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, 2021.
• WHO Consolidated Guidelines on Tuberculosis: Module 1: Prevention: Tuberculosis Preventive Treatment, 2020.
• Latent TB Infection: Updated and Consolidated Guidelines for Programmatic Management, World Health Organization, 2018.

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