Delivering and beyond: insights about the ExpandTPT community advisory board experience in Brazil

Expansion of tuberculosis (TB) preventive treatment (TPT) in contacts has been a challenge worldwide. Brazil is no exception, despite the publication of TB treatment guidelines as early as 1980. The ExpandTPT operational research programme was conducted from 2023 to 2025 in two phases across eight Brazilian high TB-burden cities to scale up TPT among contacts as per national guidelines. The programme was a partnership among the Brazilian TB Research Network (REDE-TB), the national TB programme, and civil society, consisting mainly of capacity building and local service reorganisation based on needs assessment at the municipal and clinic level. During the ExpandTPT implementation, TPT prescriptions increased by 70% in the five participating cities, which is a 30% increase in overall national TPT prescriptions from 2023 to 2024. In this viewpoint, we describe the working method of the ExpandTPT community advisory board, its key elements, role in the programme, and the authors' insights into its challenges and contribution to community engagement in TB research. Lessons learned from this experience may contribute to other operational research projects in public health.