very_low

In selected high-risk household contacts of patients with multidrug-resistant tuberculosis,
preventive treatment may be considered based on individualized risk assessment and a sound
clinical justification.

Either a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) can be used to
test for LTBI.

The absence of any symptoms of TB and the absence of abnormal chest radiographic
findings may be used to rule out active TB disease among HIV-negative household contacts
aged ≥ 5 years and other risk groups before preventive treatment.

Systematic LTBI testing and treatment is not recommended for people with diabetes, people
who engage in the harmful use of alcohol, tobacco smokers and underweight people, unless
they also belong to other risk groups included in the above recommendations.

All pregnant women with active TB should
receive multiple micronutrient supplements that
contain iron and folic acid and other vitamins and
minerals, according to the United Nations Multiple
Micronutrient Preparation, to complement their
maternal micronutrient needs.

A daily multiple micronutrient supplement at 1×
recommended nutrient intake should be provided
in situations where fortified or supplementary foods
should have been provided in accordance with
standard management of moderate undernutrition
but are unavailable.

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.

Pregnant women with active TB and moderate
undernutrition, or with inadequate weight gain,
should be provided with locally available nutrient-rich or fortified supplementary foods, as necessary to
achieve an average weekly minimum weight gain of
approximately 300 g in the second and third trimesters.

Children who are less than 5 years of age with active
TB and moderate undernutrition should be managed
as any other children with moderate undernutrition.
This includes provision of locally available nutrient-rich or fortified supplementary foods, in order to
restore appropriate weight-for-height.

Children who are less than 5 years of age with active
TB and severe acute malnutrition should be treated
in accordance with the WHO recommendations for
the management of severe acute malnutrition in
children who are less than 5 years of age.