# Tuberculosis prevention in children, adolescents, and pregnant and postpartum women in South Africa

## TL;DR

The paper discusses strategies to prevent tuberculosis in vulnerable groups in South Africa, emphasizing a comprehensive approach including vaccines and therapies.

## Contribution

It introduces a multipronged prevention framework tailored for children, adolescents, and pregnant/postpartum women.

## Key findings

- Pharmacological interventions like BCG vaccination and TB preventive therapy regimens are reviewed for CAPPW.
- The paper highlights the importance of combining infection control with psychosocial and nutritional support.
- It provides evidence-based recommendations for TPT regimens and their safety in vulnerable populations.

## Abstract

Tuberculosis (TB), particularly drug-resistant TB (DR-TB), remains a major public health concern in South Africa (SA), with children, adolescents, and pregnant and postpartum women (CAPPW) facing heightened risks because of biological and social vulnerabilities. This article highlights the importance of a multipronged prevention framework that combines infection control measures, psychosocial support, education, and nutritional supplementation, alongside pharmacological interventions such as Bacillus Calmette-Guérin (BCG) vaccination and tailored TB preventive therapy (TPT). Drawing on national guidelines and recent academic literature, the article provides an overview of current evidence and recommendations for TPT regimens (including 6H, 3HP, 3RH, 4R, 12H, and 6LFX) and their eligibility, safety considerations, drug interactions, and formulations suitable for CAPPW. By strengthening awareness and streamlining guideline-based prevention efforts, the article equips healthcare workers to make informed, patient-centred decisions to improve treatment outcomes and ultimately reduce TB transmission in high-burden settings.