Health care facility level: The panel recommends that facility-based HAI surveillance should be performed to guide IPC
interventions and detect outbreaks, including AMR. Surveillance with timely feedback of results to healthcare workers and stakeholders is essential and should be carried out through national networks.

Health care facility level: The panel recommends that IPC education should be in place for all healthcare workers
by utilizing team- and task-based strategies that are participatory and include bedside and
simulation training to reduce the risk of HAIs and AMR.

Triage of people with TB signs and
symptoms, or with TB disease, is
recommended to reduce M. tuberculosis
transmission to health workers, persons
attending health care facilities or other
persons in settings with a high risk
of transmission.

Xpert MTB/RIF may be used as a replacement test for usual practice (including conventional
microscopy, culture or histopathology) for testing specific non-respiratory specimens (lymph
nodes and other tissues) from patients suspected of having extrapulmonary TB.

Xpert MTB/RIF should be used in preference to conventional microscopy and culture as the
initial diagnostic test for cerebrospinal fluid specimens from patients suspected of having TB
meningitis.

Routine co-trimoxazole prophylaxis should be given to all HIV-infected patients with active TB
disease regardless of CD4 cell count.

For infants and children infected with HIV younger than 3 years, ABC + 3TC + AZT is
recommended as an option for children who develop TB while on an ART regimen containing
NVP or LPV/r. Once TB therapy has been completed, this regimen should be stopped and the
initial regimen should be restarted.

ART should be started in any child with active TB disease as soon as possible and within 8
weeks following the initiation of antituberculosis treatment regardless of the CD4 cell count
and clinical stage.

In settings with a high burden of HIV and TB, TB treatment may be provided for people
living with HIV in HIV care settings where a TB diagnosis has also been made.

In settings with a high burden of HIV and TB, ART should be initiated for people living with HIV
in TB treatment settings, with linkage to ongoing HIV care and ART.