TB Preventive Therapy (TPT) For TB Exposure/ Infection
Screen all children in close contact with an infectious pulmonary TB case for TB disease. Screening includes clinical history and examination with appropriate investigations of children with suspected TB disease. Give full anti-tuberculosis treatment if the diagnosis of TB disease is confirmed or suspected. Indications for TB Preventive Therapy (TPT): All asymptomatic children and adolescents, i.
Screen all children in close contact with an infectious pulmonary TB case for TB disease. Screening includes clinical history and examination with appropriate investigations of children with suspected TB disease. Give full anti-tuberculosis treatment if the diagnosis of TB disease is confirmed or suspected.
Indications for TB Preventive Therapy (TPT):
- All asymptomatic children and adolescents, i.e. clinically well, normal chest X-ray irrespective of TST, in close contact with an infectious pulmonary TB case should receive TPT.
- Previous TPT or treatment does not protect the child against subsequent TB exposure/infection. If there is a new exposure to an infectious pulmonary TB case after completion of a course of TPT, it can be given again. TPT should be repeated after each episode of documented TB exposure. In cases of a new exposure to an infectious source case while the child is on TPT, the duration of TPT should continue for at least as long as the source case remains infectious.
Preventive therapy in case of a drug-susceptible TB contact:
- Isoniazid, oral, 10 mg/kg daily for 6 months.
Preventive therapy in case of a drug-resistant TB contact:
Isoniazid monoresistance (rifampicin susceptible):
- Rifampicin, oral, 15 mg/kg daily for 4 months.
Rifampicin monoresistance (isoniazid susceptible):
- Isoniazid, oral, 10 mg/kg daily for 6 months.
MDR-TB with second line sensitivity:
- Levofloxacin 15–20 mg/kg daily for 6 months (maximum dose: 1000mg)
AND/OR
- Isoniazid, oral, 15–20 mg/kg daily for 6 months (maximum dose: 600mg)
Refer case or discuss with specialist if simplification of prophylaxis regimen is required.
XDR-TB:
- Close follow-up for two years.
- Ensure household infection control practices are observed.
- Refer all cases.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 10: Tuberculosis, 10.5 TB Preventive Therapy (TPT) For TB Exposure/Infection