Experiences from Ukraine in expanding TB infection diagnosis and treatment, including for drug-resistant TB

Background Ukraine faces intersecting epidemics of HIV and drug-resistant TB (DR-TB), with high risk of progression from TB infection to active disease. The Support TB Control Efforts in Ukraine project supported the National TB Program's efforts to operationalise World Health Organization recommendations on TB infection testing and TB preventive treatment (TPT) across 17 regions of Ukraine. Design In September 2021, QuantiFERON-TB Gold Plus (QFT-Plus) testing was introduced through a public-private laboratory model. Eligible populations included TB contacts and other high-risk groups. Data on referrals, test outcomes, and TPT initiation were collected electronically and analysed descriptively. Results Out of 11,495 individuals referred for testing, 9,788 (85.2%) completed QFT-Plus testing, with adult TB contacts showing the highest positivity rate at 28.1%. Among 1,717 eligible for TPT, 1,512 (88.1%) started TPT, and this was 93.3% for drug-susceptible TB (DS-TB) contacts and 82.8% for DR-TB contacts. DS-TB contacts were offered shorter rifapentine-based regimens, while DR-TB contacts received levofloxacin. Implementation challenges were addressed through training and mentorship. Conclusion Ukraine's implementation of QFT-Plus testing and shorter TPT regimens marks progress in broadening TB prevention efforts, particularly for DR-TB contacts. These initial results highlight that such approaches are feasible even in challenging, high-burden environments, offering insights for future expansion.