A 4-year-old asymptomatic child is a household contact of a father with sputum-positive pulmonary tuberculosis. The child's tuberculin skin test shows 12 mm induration, chest X-ray is normal, and the child is immunocompetent. What is the appropriate management?

• A Isoniazid prophylaxis 10 mg/kg once daily for 6 months ✓
• B No treatment, only clinical follow-up every 6 months
• C Full 6-month ATT with four drugs
• D Isoniazid plus rifampicin for 3 months

Explanation

Children under 6 years who are household contacts of sputum-positive pulmonary TB receive isoniazid preventive therapy at 10 mg/kg once daily for 6 months after ruling out active disease, regardless of BCG status, because young children are at high risk of progression from recent infection to severe disease. Full four-drug ATT is unwarranted with a normal chest X-ray and no symptoms, and observation alone ignores the high risk of dissemination in this age group.

Reference: Central TB Division, Ministry of Health and Family Welfare, Paediatric TB Management Guidelines, NTEP ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.