This guideline covers preventing, identifying and managing latent and active tuberculosis (TB) in children, young people and adults. It aims to improve ways of finding people who have TB in the community and recommends that everyone under 65 with latent TB should be treated. It describes how TB services should be organised, including the role of the TB control board.
In May 2016, recommendation 220.127.116.11 was clarified to reflect the sequencing of tests. Reference to IGRA status was removed from recommendations 18.104.22.168; 22.214.171.124-18; 126.96.36.199; 188.8.131.52 and 184.108.40.206.
The guideline includes recommendations on:
- preventing TB, including in under-served groups
- diagnosing and managing latent TB, including recommendations specifically for children and young people
- diagnosing and managing active TB, including recommendations specifically for children and young people
- drug-resistant TB
- infection control
- case finding and adherence, treatment completion and follow-up, including in under-served groups
Who is it for?
- Healthcare professionals and TB multidisciplinary teams
- Substance misuse services, prisons and immigration removal centres
- Local government and commissioners
- TB control boards, directors of public health and public health consultants
- Public Health England and NHS England
- Voluntary sector workers
- People with TB and their carers
Guideline development process
This guideline updates and replaces tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control (CG117) and incorporates NICE’s guideline on identifying and managing tuberculosis among hard-to-reach groups (PH37).
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.