TB Preventive Therapy (TPT)

The most effective method of preventing the spread of tuberculosis is the detection and effective treatment of infectious cases, i.e. the bacteriologically confirmed cases. Poor hygiene, malnutrition and overcrowding in places such as prisons, orphanages, facilitate the spread of tuberculosis.

TPT is recommended for the following at risk groups

Adults and adolescents living with HIV

Adults and adolescents (10 years and older) living with HIV (PLHIV) regardless of immune status, previous TB treatment or ART status
Infants and Children who are living with HIV
Infants (aged < 12 months) living with HIV who are in contact with a case of TB
Children (aged ≥ 12 months to 10yrs) living with HIV unlikely to have TB disease on symptomatic screening with or without history of TB contact

HIV negative Infants and children who are contacts of bacteriologically confirmed pulmonary TB

Other HIV-negative at-risk individuals

Miners and ex-miners with silicosis
Close and household contacts of bacteriologically confirmed pulmonary TB patients
Patients receiving immunosuppressive treatment
Patients with Chronic Kidney
Undernourished Individuals
Incarcerated populations (Inmates) who are in close contact with bacteriologically confirmed pulmonary TB

Health Care workers who meet the criteria of having additional risks for TB s.a HIV, diabetes

NB: Before giving TPT always rule out the possibility of active TB in the individual

TB Preventive Therapy Options
There are three regimens that are recommended for treatment of TBI in Zambia. The treatment regimen
depends on the patient category. These include 6 months, 3 months and 1 month regimens.

TB preventive regimens, dosing, and cautions

Drug regimen	Patient category	Dose per kg body weight	Maximum dose	Frequency	Duration	Cautions
Isoniazid (H)	PLHIV, other risk groups	Adults: 5 mg Children: 10 mg (range: 7–15 mg)	300 mg	Once daily	6–9 months	Isoniazid -containing regimens must be given with pyridoxine (B6)
Rifapentine plus isoniazid (3HP)	PLHIV, Other risk groups	Isoniazid Individuals aged ≥12 years: 15mg Individuals aged 2–11 years: 25mg Rifapentine 10.0–14.0 kg =300 mg 14.1–25.0 kg = 450mg 25.1–32.0 kg = 600mg 32.1–49.9 kg = 750 mg ≥ 50.0 kg = 900mg	Isoniazid: 900 mg Rifapentine: 900 mg	Once weekly	3 months	Isoniazid-containing regimens must be given with pyridoxine (B6)
Isoniazid plus Rifampicin (RH)	Other risk groups, PLHIV	Isoniazid Adults: 5 mg Children: 10 mg (range: 7–15 mg) Rifampicin Adults: 10 mg Children: 15 mg (range: 10–20 mg)	Isoniazid: 300 mg Rifampicin: 600 mg	Once daily	3–4 months	Isoniazid -containing regimens must be given with pyridoxine (B6)
Rifapentine plus isoniazid (1HP)	HIV negative household contacts above 13 years Incarcerated Populations PLHIV	Isoniazid: 5mg Rifapentine: 10mg	Isoniazid: 300 mg Rifapentine: 600 mg	Once daily	1 month	Isoniazid- containing regimens must be given with pyridoxine (B6) 25 mg daily