Attribution 4.0 International (CC BY 4.0)Yates, Tom A.Karat, Aaron S.Bozzani, FiammettaMcCreesh, NickyMacGregor, HayleyBeckwith, Peter G.Govender, IndiraColvin, Christopher J.Kielmann, KarinaGrant, Alison D.2023-08-102023-08-102023-07-17Yates, T.A., Karat, A.S., Bozzani, F., McCreesh, N., MacGregor, H., Beckwith, P.G., Govender, I., Colvin, C.J., Kielmann, K. and Grant, A.D. (2023) ‘Time to change the way we think about tuberculosis infection prevention and control in health facilities: insights from recent research’, Antimicrobial Stewardship & Healthcare Epidemiology, 3(1), p. e117. Available at: https://doi.org/10.1017/ash.2023.192.2732-494Xhttps://eresearch.qmu.ac.uk/handle/20.500.12289/13395https://doi.org/10.1017/ash.2023.192Aaron S Karat - ORCID: 0000-0001-9643-664X https://orcid.org/0000-0001-9643-664XKarina Kielmann - ORCID: 0000-0001-5519-1658 https://orcid.org/0000-0001-5519-1658In clinical settings where airborne pathogens, such as Mycobacterium tuberculosis, are prevalent, they constitute an important threat to health workers and people accessing healthcare. We report key insights from a 3-year project conducted in primary healthcare clinics in South Africa, alongside other recent tuberculosis infection prevention and control (TB-IPC) research. We discuss the fragmentation of TB-IPC policies and budgets; the characteristics of individuals attending clinics with prevalent pulmonary tuberculosis; clinic congestion and patient flow; clinic design and natural ventilation; and the facility-level determinants of the implementation (or not) of TB-IPC interventions. We present modeling studies that describe the contribution of M. tuberculosis transmission in clinics to the community tuberculosis burden and economic evaluations showing that TB-IPC interventions are highly cost-effective. We argue for a set of changes to TB-IPC, including better coordination of policymaking, clinic decongestion, changes to clinic design and building regulations, and budgeting for enablers to sustain implementation of TB-IPC interventions. Additional research is needed to find the most effective means of improving the implementation of TB-IPC interventions; to develop approaches to screening for prevalent pulmonary tuberculosis that do not rely on symptoms; and to identify groups of patients that can be seen in clinic less frequently.e117en© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of Americahttp://creativecommons.org/licenses/by/4.0/Commentary: Time to change the way we think about tuberculosis infection prevention and control in health facilities: insights from recent researchArticle