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On April 12-13, 2015, over 50 global experts in tuberculosis convened for the Global Consultation on Best Practices in the Delivery of Preventive Therapy for Households Exposed to Drug-Resistant Tuberculosis (DR-TB). The meeting was hosted by the newly established Harvard Medical School Center for Global Health Delivery–Dubai, in Dubai, United Arab Emirates. The meeting’s aim was to convene key specialists and leaders in the field to share experiences treating tuberculosis infection in both adult and child household contacts of patients with DR-TB.
The two-day meeting brought together providers, researchers, policy-makers, and industry representatives from 17 countries across Asia, Africa, the Americas, and Europe. Meeting participants were from non-governmental organizations, academic research institutions, national and global organizations, and pharmaceutical companies. Represented organizations included the Clinton Health Access Initiative, Global Health Committee, Partners In Health, Interactive Research and Development, the U.S. Centers for Disease Control and Prevention, Indus Hospital, Baylor College of Medicine, Stellenbosch University, Stop TB Partnership, and Janssen Global, among many others.
April 12 began with presentations describing the current lack of clear guidance on preventive therapy for contacts of DR-TB. The meeting then moved into presentations from programs and hospitals that have provided preventive therapy to these contacts. Experiences from the United States, South Africa, Argentina, the United Kingdom, and the Federated States of Micronesia were presented. Following presentations, breakout groups met to discuss key questions around the screening and post-exposure treatment of households exposed to DR-TB. To close out the first day of the meeting, the larger group came together to gather outcomes from the small group discussions.
The second day, April 13, saw presentations from programs considering the use of preventive therapy in household contacts of DR-TB patients in South Africa, Pakistan, and Swaziland. The final presentation of the meeting focused on the development of a practical guidance document in the form of a post-exposure protocol for households exposed to DR-TB. Breakout groups then met again to discuss the implementation of screening and post-exposure treatment, as well as desired meeting outcomes. To close out the meeting, the group reconvened and gathered outcomes of the small group discussions.
Overall, the meeting was met with exceptionally positive feedback. A remarkable level of consensus was reached regarding not only the likely benefit of preventive therapy in contacts of DR-TB patients, but also in terms of identifying key treatment principles that can guide providers today and expand the growing evidence base to improve care for households exposed to DR-TB. Meeting proceedings will follow as well as a formal consensus statement from the group gathered in Dubai.