Bridging programmatic gap in post-TB treatment prevention: applying the COM-B model and Behavior Change Wheel to improve the uptake of TB preventive therapy

Abstract

Tuberculosis preventive therapy (TPT) is a core component of the global tuberculosis (TB) control strategies and aims to reduce progression from Mycobacterium tuberculosis (MTB) infection to TB disease (hereafter, TB), including preventing recurrent TB.1, 2 The World Health Organization recommends TPT policies should be developed for other populations at risk, including those most likely to be exposed to TB and those at high risk of progression from infection to the disease.3 The Uganda Ministry of Health, through the National Tuberculosis and Leprosy Program (NTP), recommends the initiation of TPT immediately after completion of TB treatment (hereafter, post-TB treatment TPT or PTT-TPT).4 Immediate PTT-TPT targets people with retreatment TB (i.e., people previously treated for TB) who remain at elevated risk for future TB. Among others, the NTLP guideline states, "TPT should also be given to those who have previously been treated for TB immediately after completing TB treatment.".