• Michelle Lay Teng Ang, Si Min Chan, Lionel Tim-Ee Cheng, Hau Yiang Cheong, Ka Lip Chew, Piotr Maciej Chlebicki, Li Yang Hsu, Gregory Jon Leng Kaw, Adrian Chin Leong Kee, NgMark Chung WaiMCWSingHealth Polyclinics, Singapore Health Services, Singapore., Rick Twee Hee Ong, Catherine Wei Min Ong, Jessica Lishan Quah, D/O Balasubramaniam Selvamani, Li Hwei Sng, Jamie Bee Xian Tan, Cher Heng Tan, Jun Yang Tay, Lynette Li San Teo, Koh Cheng Thoon, Gabriel Zherong Yan, Jacinta I-Pei Chen, Bin Mohammed Helmi Hud, Benjamin Bing Jie Khoo, Dawn Yi Xin Lee, Bob Xian Yi Ng, Jia Ying Park, Belinda Ying Ting Tan, and Qian Yang.
• National Public Health Laboratory, National Centre for Infectious Diseases, Singapore.
• Ann Acad Med Singap. 2024 Mar 27; 53 (3): 170186170-186.

IntroductionTuberculosis (TB) remains endemic in Singapore. Singapore's clinical practice guidelines for the management of tuberculosis were first published in 2016. Since then, there have been major new advances in the clinical management of TB, ranging from diagnostics to new drugs and treatment regimens. The National TB Programme convened a multidisciplinary panel to update guidelines for the clinical management of drug-susceptible TB infection and disease in Singapore, contextualising current evidence for local practice.MethodFollowing the ADAPTE framework, the panel systematically reviewed, scored and synthesised English-language national and international TB clinical guidelines published from 2016, adapting recommendations for a prioritised list of clinical decisions. For questions related to more recent advances, an additional primary literature review was conducted via a targeted search approach. A 2-round modified Delphi process was implemented to achieve consensus for each recommendation, with a final round of edits after consultation with external stakeholders.ResultsRecommendations for 25 clinical questions spanning screening, diagnosis, selection of drug regimen, monitoring and follow-up of TB infection and disease were formulated. The availability of results from recent clinical trials led to the inclusion of shorter treatment regimens for TB infection and disease, as well as consensus positions on the role of newer technologies, such as computer-aided detection-artificial intelligence products for radiological screening of TB disease, next-generation sequencing for drug-susceptibility testing, and video observation of treatment.ConclusionThe panel updated recommendations on the management of drug-susceptible TB infection and disease in Singapore.

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