treat for other possibilities and re-evaluate confirm diagnosis isoniazid prophylaxis for all children < 5 years register and treat for TB

A child under 5 years of age living with a sputum smear-positive PTB patient is at high risk of TB infection and developing TB disease, especially if HIV-positive. Tuberculin skin testing is not a reliable way of distinguishing TB-infected from non-TB-infected children and is often not available. The IUATLD therefore recommends isoniazid preventive treatment for all child household contacts (under 5 years of age) of sputum smear-positive PTB patients.The preventive treatment should be based on the drug sensitivity profile of the likely source of infection, whenever this profile is available.

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