Person-centred language for describing stratified approaches to TB treatment

Person-centred language for describing stratified approaches to TB treatmentDear Editor, The prevailing 'one-size-fits-all' treatment paradigm for TB is changing with the recognition of the potential benefits of stratifying treatment based on the characteristics of the person with TB and disease presentation. 1-4This shift is part of a larger movement to make TB care more effective, safe and person-centered.Another key aspect is ensuring the language used in TB care is purposeful, clear and non-stigmatizing. 5,6This raises the question of the most appropriate language to describe novel stratified treatment approaches to TB treatment.We therefore conducted a survey to understand the preferred terms used to describe stratified approaches to TB treatment among TB-affected communities, researchers, and providers.A short, anonymous online English language survey was conducted from May 10 to June 4, 2024.Informed by initial feedback from community partners reviewing a stratified medicine trial protocol, 10 pairs of terms were proposed.Respondents were asked to rate each as 'preferred', 'acceptable', or 'unacceptable' and provide open-ended reasons for their choice.We advertised our survey widely through directed e-mails to TB and HIV research networks' community advisory bodies, community organizations, and TB civil society listservs.The study was approved by The Johns Hopkins Medicine Institutional Review Board, Baltimore, MD, USA.In total, 108 individuals completed the survey.Respondents could select multiple identities, but most self-identified as members of civil society (66%) and/or people with lived experience with TB (43%).Healthcare providers (29%), researchers (23%) and TB program staff (21%) were represented.Respondents represented all WHO regions, with over half from the African region (57%), 19% from the South-East Asian Region, 16% from the region of the Americas (excluding the United States and Canada), 15% from the United States and Canada, 7% from Northern/Western/Southern Europe (including the United Kingdom), 3% from Eastern Europe, 2% from the Eastern Mediterranean region, and 1% from the Western Pacific region.All age groups (six categories ranging from 18 to 65) were represented, with the majority (31%) being between 35 and 44 years old.The most preferred pair of terms was 'shorter treatment and longer treatment,' with 46% of respondents indicating these terms as 'preferred' (Table ).These terms were the top preference across different demographic categories.The second and third most preferred terms also focused on the length of treatment: