Tuberculosis Preventive Therapy (TPT)

Clinical Description

• A single course of TPT can prevent active TB in people who are at high risk. Give TPT to:
• HIV infected children, adolescents and adults
• Children under 5 years – regardless of HIV status – who are household contacts of clients with bacteriologically confirmed TB (microscopy, gene

X-pert or LF TB LAM): give IPT – 6H.

• HIV patients who have completed 6 months of IPT in the past do not need another course of TPT.
• Do not give TPT to a patient who has any signs suggestive of active TB: such patients need full investigation for TB and may require full TB treatment to avoid TB drug resistance.
• New patients: Start TPT together with ART and CPT.
• Two alternative TPT options are similarly effective:
• 3HP: 3-month course of weekly doses of Isoniazid + Rifapentine
• Preferred regimen for patients newly initiating ART
• 6H: 6-month course of daily dose of Isoniazid – do not give to women in first trimester
• Use as an alternative regimen for those with contraindications to 3HP
• Suitable for children and can be combined with all ART regimens
• Both 3HP and 6H should not be routinely given in pregnancy and 3 months postpartum due to increased risk of hepatotoxicity and potential adverse birth outcomes (low birth weight and preterm delivery).
• Document all serious side effects on the yellow pharmacovigilance forms and submit to PMRA or report using the MEDSAFE-360 USSD platform.
• DO NOT RESTART TPT if any significant side effect is experienced.
• For more information, Refer to Malawi TB control guidelines/Manual (2018).