Progress and challenges in tuberculosis preventive treatment in the Western Pacific Region: a situational analysis of seven high tuberculosis burden countries

作者：Kyung Hyun Oh, Alvin Kuo Jing Teo, Manami Yanagawa, Avinash Kanchar, Dennis Falzon, Cecily Miller, Youngeun Choi, Gyeong In Lee, Fukushi Morishita, Kalpeshsinh Rahevar, Huong Thi Giang Tran, Rajendra Yadav, Anousone Sisouvanh, Bunleng Bith, Clarissa Blanca Halum, Ganpurev Byambaa, Herolyn Nindil, Huyen Thi Thanh Truong, Janet Ibay, Kim Eam Khun, Narantuya Jadambaa, Quang Hieu Vu, Sakhone Suthepmany, Serongkea Deng, Uyanga Erdenebileg, Vibol Iem, Vilath Seevisay, Walley Ambano, Zhenhong Li, Zhongdan Chen · 发表于：Tropical Medicine and Health · 年份：2025 · DOI：10.1186/s41182-025-00805-6 · 被引用次数：4 · 研究领域：Tuberculosis Research and Epidemiology、Healthcare Facilities Design and Sustainability、Immune responses and vaccinations

BACKGROUND: Tuberculosis preventive treatment (TPT) can avert progression from infection to disease, yet scale-up across the World Health Organization Western Pacific Region is patchy. To guide acceleration, we assessed progress, challenges and responses in seven high-burden countries-Cambodia, China, Lao People's Democratic Republic (PDR), Mongolia, Papua New Guinea, the Philippines and Viet Nam-drawing on 2015-2023 programme data, structured questionnaires, follow-up interviews and a regional validation workshop. MAIN BODY: Six of the seven countries have issued national TPT guidelines and five now offer shorter rifapentine- or rifampicin-based regimens. 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. Cascade analysis revealed major attrition between screening and TPT initiation. Key obstacles, viewed through a socio-ecological lens, 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 such as the absence of child-friendly formulations and non-notification of tuberculosis infection. Countries and partners endorse...