Guideline

Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries

Year of Publication

2012

Issuing Institution

WHO

Links

Google Scholar,WHO IRIS

Recommendations

8 included recommendations

It is recommended that contact investigation be conducted for household and close contacts when the index case has any of the following characteristics: has sputum smear-positive pulmonary TB, has multi-drug-resistant TB (MDR-TB or extremely-resistant TB (extensively drug-resistant tuberculosis (XDR-TB)) (proven or suspected), is a person living with HIV infection (PLHIV) or is a child < 5 years of age.

Status

New

Recommended in favor

Strong

Certainty of evidence

Very low

It is suggested that contact investigation be conducted for household and close contacts of all other index cases with pulmonary tuberculosis, in addition to the index cases covered in Recommendation 1.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

Clinical evaluation of household and close contacts for active TB is recommended as a priority on the basis of their risk for having or developing active TB or for the potential consequences of the disease if it develops. Priority should be given to: people of all ages with symptoms suggestive of TB, children < 5 years of age, people with known or suspected immunocompromising conditions (especially person living with HIV infection (PLHIV)) and contacts of index cases with multidrug-resistant tuberculosis (MDR-TB) or extensively drug-resistant tuberculosis (extensively drug-resistant tuberculosis (XDR-TB)) (proven or suspected).

Status

New

Recommended in favor

Strong

Certainty of evidence

Very low

In settings of high HIV prevalence it is recommended that all household and close contacts be counselled and tested for HIV.

Status

New

Recommended in favor

Strong

Certainty of evidence

Very low

It is recommended that all household contacts of an index case who is a person living with HIV infection (PLHIV) should be counselled and tested for HIV.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Very low

It is recommended that all household and close contacts of people with TB who have symptoms compatible with active TB should receive counselling and testing for HIV as part of their clinical evaluation.

Status

New

Recommended in favor

Conditional

Certainty of evidence

Very low

person living with HIV infection (PLHIV) who are household or close contacts of people with TB and who, after an appropriate clinical evaluation, are found not to have active TB should be treated for presumed latent tuberculosis infection (LTBI) as per WHO guidelines.

Status

New

Recommended in favor

Strong

Certainty of evidence

High

Children < 5 years of age who are household or close contacts of people with TB and who, after an appropriate clinical evaluation, are found not to have active TB should be treated for presumed latent tuberculosis infection (LTBI) as per WHO guidelines

Status

New

Recommended in favor

Strong

Certainty of evidence

High