Background
On the 25th of Mangsir 2081 (December 10, 2024), Nepal’s National Tuberculosis Control Center (NTCC) officially rolled out the “National TB Preventive Treatment Protocol 2024”. This major public health update aims to provide Tuberculosis Preventive Treatment (TPT) to individuals most at risk of developing active TB, especially children and immunocompromised individuals.
This protocol aligns with Nepal’s ongoing efforts to meet WHO’s End TB Strategy 2035 and strengthens the nation’s commitment under Global Health Security frameworks.
What’s New in the TPT Protocol 2024?
The updated protocol focuses on three high-priority groups for preventive TB treatment (TPT):
| Age Group | Regimen | Note |
|---|---|---|
| Children < 2 years (HIV-negative) | 3HR | 3 months of daily Isoniazid + Rifampicin |
| Children < 2 years (HIV-positive) | 6H | 6 months of daily Isoniazid |
| Children 2–5 years | 3HP | 3 months of once-weekly Isoniazid + Rifapentine |
👉 These regimens are based on global evidence and have been endorsed by WHO for latent TB infection (LTBI) treatment.
Who is Eligible for TPT Under the New Protocol?
The updated guidelines focus on:
- People living with HIV (PLHIV)
- Children in close contact with bacteriologically confirmed pulmonary TB (PBC) cases
- Household contacts detected during contract tracing
- Those exposed to Active TB Cases
These groups will receive treatment through the DOTS center network after being declared eligible for TPT as per the new protocol.
Implementation and Monitoring
The NTCC requests all Provincial Health Directorates and District Health Offices to operationalize the protocol immediately. Additional guidance is to be followed via:
- NTCC’s official website: www.nepaltb.gov.np
- Standard Operating Procedures and programmatic guidance available from central and provincial authorities.
📍 Note: For individuals aged above 5 years, TPT should only be provided after confirming they have latent TB infection (LTBI) through symptom screening and testing.
🌍 Public Health Significance
- Reduces risk of TB disease in vulnerable children and PLHIV.
- Prevents transmission within households and communities.
- Aligns with International Health Regulations (IHR 2005) and GHSA targets to strengthen early prevention.
“This is a critical step toward eradicating TB from Nepal and protecting the most vulnerable populations with scientifically approved regimens.”
— Dr. Shreeram Tiwari, Director, NTCC
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