in_the_evidence

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.

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

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.

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.

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.

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.