conditional

Systematic LTBI testing and treatment may be considered for prisoners, health workers,
immigrants from countries with a high TB burden, homeless people and people who use drugs.

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.

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.

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.

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.

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.