Tuberculosis Preventive Treatment in the Western Pacific Region: Assessing Progress and Challenges

Strategic Insights -

Research presented by World Health Organization Regional Office Western Pacific reveals the patchy scale-up of tuberculosis preventive treatment (TPT) across the World Health Organization Western Pacific Region. To guide acceleration, the study assessed progress, challenges, and responses in seven high-burden countries: Cambodia, China, Lao People's Democratic Republic, Mongolia, Papua New Guinea, the Philippines, and Viet Nam. The results showed that six of the seven countries have issued national TPT guidelines and five offer shorter rifapentine- or rifampicin-based regimens.

Key Takeaways:

  • Six out of seven countries have issued national TPT guidelines to guide the implementation of preventive treatment.
  • Five countries now offer shorter regimens, including rifapentine- or rifampicin-based treatments, to make preventive treatment more accessible and effective.
  • The number of people started on TPT rose sharply in most settings, driven by household contacts aged 5 years in Cambodia, Mongolia, and the Philippines, and by people living with HIV in Lao PDR and Papua New Guinea.
  • However, coverage of children under five and other high-risk groups remains low, with major attrition between screening and TPT initiation.
  • Key obstacles to TPT implementation include individual complacency, fear of adverse events, and limited provider confidence; stigma and consent barriers in migrant households; intermittent staff training, medicine stock-outs, and weak digital tools; long journeys to health facilities; and policy-practice gaps.
  • A tiered package combining patient-centred counselling, mobile reminders, shorter paediatric regimens, stigma-reduction campaigns, and remote e-consent has been endorsed by countries and partners to address these challenges.
  • Health systems will reinforce staff training, digital supply-chain, and adherence tools, while decentralised one-stop outreach and community health-workers will extend coverage.
  • A multisector task force will fast-track paediatric fixed-dose registration, make infection notifiable, and absorb preventive treatment costs into national budgets and insurance schemes.

Statistics:

  • Six out of seven countries have issued national TPT guidelines.
  • Five countries offer shorter regimens, including rifapentine- or rifampicin-based treatments.
  • The number of people started on TPT rose sharply in most settings.
  • 122 people were included in the research study.

Sources:

  • Tropical Medicine and Health

Bmc, Campus, 4 Crinan St, London N1 9XW, England

  • Kyung Hyun Oh, World Health Organization Regional Office Western Pacific, Manila, Philippines
  • Researchers' Work from World Health Organization Regional Office Western Pacific

TB & Outbreaks Week. September 16, 2025; p 1176.