Neonate born to a mother with pulmonary TB during pregnancy who is not infectious at delivery

If a mother with pulmonary TB during pregnancy has been on TB treatment for more than 2 months before delivery and has evidence of treatment efficacy (clinical improvement and either smear- or culture-negative), the mother is considered not infectious and there is a low risk of transmission to the neonate.

Congenital TB should still be excluded in the neonate, but they do not require presumptive treatment for latent TB. The infant should have monthly clinical review up to 3 months of age.

Perform a tuberculin skin test (TST) on the infant at 3 months of age. If the TST is:

• positive—assess the infant for active TB; if active TB is excluded, treat the infant for latent TB
• negative—recommend Bacille Calmette-Guérin (BCG) vaccination if the infant is at risk of future exposure to TB. If the mother is HIV positive, exclude HIV infection in the infant before giving BCG.