WHO_UCN_TB_2020_1_8
People who are initiating anti-TNF treatment, or receiving dialysis, or preparing for an organ
or haematological transplant, or who have silicosis should be systematically tested and treated
for LTBI.
People who are initiating anti-TNF treatment, or receiving dialysis, or preparing for an organ
or haematological transplant, or who have silicosis should be systematically tested and treated
for LTBI.
Children aged < 5 years who are household contacts of people with bacteriologically
confirmed pulmonary TB and who are found not to have active TB on an appropriate clinical
evaluation or according to national guidelines should be given TB preventive treatment even
if LTBI testing is unavailable.
Children aged ≥ 12 months living with HIV who are considered unlikely to have active TB
on an appropriate clinical evaluation or according to national guidelines should be offered TB
preventive treatment as part of a comprehensive package of HIV prevention and care if they live
in a setting with high TB transmission, regardless of contact with TB.
Infants aged < 12 months living with HIV who are in contact with a person with TB and who
are unlikely to have active TB on an appropriate clinical evaluation or according to national
guidelines should receive TB preventive treatment.
Either a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) can be used to
test for LTBI.
Adults and adolescents living with HIV who are screened for TB according to a clinical algorithm
and who report any of the symptoms of current cough, fever, weight loss or night sweats may have
active TB and should be evaluated for TB and other diseases and offered preventive treatment
if active TB is excluded.
Adults and adolescents living with HIV who are unlikely to have active TB should receive TB
preventive treatment as part of a comprehensive package of HIV care. Treatment should be
given to those on antiretroviral treatment, to pregnant women and to those who have previously
been treated for TB, irrespective of the degree of immunosuppression and even if LTBI testing
is unavailable.
For people with severe mental disorders and TB, non-pharmacological (social, psychological) management
should be considered in accordance with the WHO guidelines for the treatment of drug-susceptible tuberculosis
and patient care and the WHO treatment guidelines for drug-resistant tuberculosis.
For people with severe mental disorders and TB, pharmacological management should be considered in
accordance with the WHO guidelines for the treatment of drug-susceptible tuberculosis and patient care and the
WHO treatment guidelines for drug-resistant tuberculosis.
Patients with active multidrug-resistant TB and
moderate undernutrition should be provided with
locally available nutrient-rich or fortified supplementary
foods, as necessary to restore normal nutritional status.