The effective implementation of this recommendation and the other recommendations in these guidelines relies on the understanding that interventions within the three-level hierarchy of IPC should not be prioritized individually or implemented separately, but must be considered as an integrated package of IPC interventions. Implementation of any triage system needs to be focused on fast-tracking of presumed TB cases and on minimizing time in the facility. Consultation and ongoing dialogue with both health care staff and patients should be considered, to provide feedback that could facilitate the implementation of the recommendation without contributing to stigma or alienation of patients. The considerations outlined below should guide the implementation of the recommendations. Settings and target population The recommendation on the implementation of triage of people with TB signs and symptoms as a means of reducing M. tuberculosis transmission to health workers or other persons attending relevant facilities applies explicitly to health care settings. Although the scope of the review was limited to such settings, the Guideline Development Group recognized that it is vital to implement triage in other settings with a high risk of M. tuberculosis transmission where persons with presumed TB may congregate (e.g. long-term care and correctional facilities), regardless of the burden of TB disease. In addition, community health workers are key to promptly identifying presumptive TB cases at the community level and making use of referral systems, to fast-track TB diagnosis and facilitate the implementation of other interventions. Community health workers could help to improve the early detection of TB cases, and reduce the risk of transmission in the community in general. Resources The effective implementation of triage goes beyond the minimal infrastructure requirements (e.g. conditions for fast-tracking of patients with presumed TB, rapid diagnosis, respiratory separation, use of data-recording tools for documentation, and analysis of data for developing or changing evidencebased policies). The implementation needs to prioritize the availability, education, sensitization and continuous training of health care providers and others working in settings with a high risk of M. tuberculosis transmission. Subgroup considerations In line with current guidelines on screening for active TB disease, people living with HIV should be systematically screened for active TB at each visit to a health care facility (31, 32). Similarly, routine HIV testing should be offered to all patients with presumptive and diagnosed TB, especially in high HIV burden settings (33). Triage systems may be part of collaborative activities established to prevent and identify TB across other disease programmes (e.g. diabetes and conditions that increase the risk of LTBI or TB disease).