low

Children aged ≥ 5 years, adolescents and adults who are household contacts of people
with bacteriologically confirmed pulmonary TB who are found not to have active TB by an
appropriate clinical evaluation or according to national guidelines may be given TB preventive
treatment.

All children living with HIV who have successfully completed treatment for TB disease may
receive TB preventive treatment.

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.

In settings with high TB transmission, adults and adolescents living with HIV who have an
unknown or a positive LTBI test and are unlikely to have active TB disease should receive at least
36 months of daily isoniazid preventive treatment (IPT). Daily IPT for 36 months should be given
whether or not the person is on ART, and irrespective of the degree of immunosuppression,
history of previous TB treatment and pregnancy, in settings considered to have a high TB
transmission as defined by national authorities.

Chest radiography may be offered to people living with HIV on ART and preventive treatment
be given to those with no abnormal radiographic findings.

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.

School-age children and adolescents (5 to 19 years),
and adults, including lactating women, with active
TB and moderate undernutrition, who fail to
regain normal body mass index after 2 months of TB
treatment, as well as those who are losing weight
during TB treatment, should be evaluated for
adherence and comorbid conditions. They should
also receive nutrition assessment and counselling
and, if indicated, be provided with locally available
nutrient-rich or fortified supplementary foods as

Current and former workers in workplaces with silica
exposure should be systematically screened for active TB.

Children living with HIV who have any of the following symptoms – poor weight gain, fever or
current cough or contact history with a TB case – may have TB and should be evaluated for TB and
other conditions. If the evaluation shows no TB, children should be offered IPT regardless of their
age.