Isolation procedures

• Pre-pubertal children who are suspected of having TB are of low infection risk to others as children rarely develop cavitary disease.
• Isolate all children > 8 years who are being treated for TB, especially if the child is coughing a lot and has cavities on CXR and/or is SSP.
• Even if the child is not considered a risk due to age, consider if the guardian is an infection risk, are they coughing too? Order a CXR for the guardian and refer to the TB officer.

Note: Chemotherapy rapidly reduces infectiousness, usually within 2 weeks, if the bacilli are susceptible. If an inpatient - isolate for 14 days as it takes TB drugs about 10-14 days to sterilise the lungs. If the child is stable discharge as soon as possible. Advise the child/parent to avoid crowded areas (e.g. minibus taxis, crowded wards, the HIV clinic etc.) & to spend time outside in a well-ventilated area.

Enquire if there are other young children at home. If one child has TB then it is likely that others are infected too. Refer any children <5 years of age to the TB clinic for screening

Disseminated tuberculosis is the result of spread of bacilli via the blood stream, which then seeds into the lungs, liver, spleen and brain. The earliest symptoms of disseminated tuberculosis are a loss of energy and activity, weight loss and fever.