TB Exposed children/neonate and IPT


TB-exposed child

Neonates exposed to an SSP Mother

The following scenarios are a guide on what to do:

Two common scenarios

Mother was diagnosed with TB prior to the third trimester of pregnancy, is taking TB medications with good adherence and is clinically well:

Mother is diagnosed with TB in the third trimester of pregnancy or shortly after delivery

Examine her baby closely for symptoms and signs of disease - two further possible scenarios

Isoniazid dose

Weight band Dose of Isoniazid
< 2.5 Kg 25 mg (1/4 tablet) every 24 hours
2.5 -5 kg 50 mg (1/2 tablet) every 24 hours
5-10kg 100 mg (1 tablet) every 24 hours

Infants need to be reviewed at 1, 3 and 6 months after commencing isoniazid. Infants' weights must be checked regularly and their isoniazid dosages increased as they grow. Refer all other household children to the TB clinic for clinical assessment and screening. As BCG is a live vaccine, isoniazid will kill the vaccine and prevent an effective immune response from developing. If isoniazid is commenced within 2 weeks of receiving BCG vaccination, the infant will need repeat BCG vaccination following the end of treatment. If no BCG vaccine was given at birth, then vaccinate the baby two weeks after completing isoniazid.

  • The baby is not well and has signs/symptoms suggestive of TB disease, collect gastric aspirates, send for gene Xpert and culture where possible and commence full TB treatment.

    If any findings suggest active disease, start full anti-TB treatment, according to national guidelines.