Observation on Tuberculosis Preventive Treatment in Georgia

The uptake of latent tuberculosis infection treatment (LTBI) is an important measure to prevent active tuberculosis (TB), but has not been well studied in low and middle-income countries (LMICs). The lifetime risk of developing active TB for people with LTBI is 10-15%. Within the national guidelines of National Tuberculosis control Program (NTP) 2020 in Georgia, 6 months isoniazid preventive treatment (IPT) was replaced with 3 months rifapentine treatment. Here we present the results of the care cascade of LTBI treatment of subjects to whom the Tuberculosis Preventive Treatment (TPT) in Georgia was recommended. We performed a cohort-study during 2020-2021 in which we applied a mixed method recommended for TPT. We assessed active pulmonary TB cases to whom IPT was recommended and in cases not completing a tuberculosis preventive treatment, the respective reasons. Among 678-contactedsubjects, 54% were female and 46% were male. There was no age limit. Overall 164 participants initiated TPT, among them 107 completed the treatment. 72% from all participants were in close contact with TB-patients/ index cases and were living in the same household. 49% of index cases were positive to culture test (culture test involves studying bacteria by growing the bacteria on different substances) and 45% were Drug Sensitive Tuberculosis (DST) positive. 23 cases of index cases were MultiDrug-Resitant (MDR) TB patients. 95 (14%) participants were treated at the National Center for Tuberculosis and Lung Diseases, other participants were treated at other regions of Georgia (Kakheti, Kutaisi, Rustavi, Gori). From 22 chil-dren under 5 years of age who were recommended for the Tuberculosis Skin Test (TST), 2 were positive. Our findings highlight very low rates of LTBI treatment recommendation, initiation and completion in Georgia and hence the need for improved monitoring and treatment programs. Keywords: Communicable disease, Infectious disease, Tuberculosis, Latent tuberculosis, Prevention, Epidemiology.