A 3-year-old asymptomatic child lives in the same household as a newly diagnosed sputum smear-positive pulmonary tuberculosis patient. The child is healthy, gaining weight, and has a normal chest radiograph. As per current NTEP guidance, what is the most appropriate intervention?

• A BCG revaccination and observation for symptoms
• B Rifampicin plus isoniazid for 3 months
• C Isoniazid preventive therapy for 6 months irrespective of tuberculin skin test result ✓
• D No intervention until the child becomes symptomatic

Explanation

Household contacts below five years of a sputum-positive pulmonary TB case receive isoniazid preventive therapy for six months regardless of tuberculin status, because young children progress rapidly from infection to severe disease. Rifampicin-containing short regimens are reserved for contacts of MDR or RR-TB patients, which removes that distractor. Watchful waiting leaves latent infection untreated in the highest-risk age group, and BCG given after exposure confers no benefit.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.