Before any TB preventive therapy, active disease must be excluded. In children, ask about cough, fever, weight loss or failure to thrive, and reduced playfulness; examine for lymphadenopathy; and obtain a chest radiograph where available and indicated. Preventive monotherapy or dual therapy given to a child with unrecognised active TB risks treatment failure and drug resistance.
- Screen for cough, fever, poor weight gain and lethargy before starting preventive treatment.
- Examine for lymph nodes and check growth charts.
- Obtain a chest radiograph where symptoms or signs raise doubt.
- Review household contacts' drug-susceptibility results before choosing a regimen.
Why it matters
Preventive regimens are too weak to treat active disease and can select resistance.
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