Latent tuberculosis infection and the EndTB Strategy: ethical tensions and imperatives.

Abstract

Latent tuberculosis infection (LTBI) is increasingly recognised as central to programmatic TB activity, and a critical element in global progress towards TB elimination. LTBI affects a much larger group of people than active disease, who by definition are asymptomatic. Furthermore, while LTBI represents a state of risk, there remains significant uncertainty regarding which individuals will progress to active disease. Therefore, the development and implementation of LTBI management policies within the End TB Strategy requires careful ethical consideration. This article reviews ethical issues related to developments in LTBI diagnosis and management, including new tools and emerging policies an..