ABSTRACT BACKGROUND: The diagnosis and treatment of latent tuberculosis infection (LTBI) are crucial for tuberculosis (TB) control. Household contacts (HHC) of patients with pulmonary TB are at a high risk of LTBI due to their close proximity to source cases. OBJECTIVE: To describe the diagnosis and treatment of LTBI among HHC. DESIGN AND SETTING: This cross-sectional follow-up study was conducted in the municipality of Paulo Afonso, northeastern Brazil, between 2013 and 2022. METHODS: We retrieved secondary data from the medical records of HHC who were followed up at a specialized referral center for TB. LTBI prevalence estimates were calculated and are presented with 95% confidence intervals (CIs). RESULTS: In total, 622 HHC were screened for LTBI, with 620 evaluated using the tuberculin skin test (TST). Of these, 40 (6.5%) did not return for TST reading. The overall prevalence of LTBI was 53.1% (95% CI: 49–57.1%), with a high prevalence among females and individuals aged 25–34 years. The overall LTBI treatment initiation rate was 26.1% (95%CI: 21.5–31.3%), and 64.2% (95%CI: 53.3–73.8%) of HHC who initiated treatment completed their course. CONCLUSION: This study revealed a high prevalence of LTBI among HHC, particularly among women and individuals aged 25–34 years, underscoring the ongoing TB transmission within the community. Only 26.1% of the diagnosed HHC initiated treatment, with approximately 64% completing their course. This highlights the challenges in managing LTBI and emphasizes the need for targeted screening and interventions for high-risk groups. BACKGROUND (LTBI (TB control (HHC cases OBJECTIVE SETTING crosssectional cross sectional followup follow Afonso Brazil 201 2022 METHODS 95 CIs. CIs . (CIs) RESULTS total 62 TST. (TST) these 4 6.5% 65 6 5 (6.5% reading 531 53 1 53.1 (95 CI 49–57.1%, 49571 49–57.1% , 49 57 49–57.1%) 2534 25 34 25–3 years 261 26 26.1 95%CI 95CI (95%CI 21.5–31.3%, 215313 21.5–31.3% 21 31 3 21.5–31.3%) 642 64 2 64.2 53.3–73.8% 533738 73 8 course CONCLUSION community highrisk groups 20 202 9 (CIs (TST 6.5 (6.5 53. (9 4957 49–57.1 253 25– 26. 21531 21.5–31.3 64. 53.3–73.8 53373 7 6. (6. ( 495 49–57. 2153 21.5–31. 53.3–73. 5337 (6 49–57 215 21.5–31 53.3–73 533 49–5 21.5–3 53.3–7 49– 21.5– 53.3– 21.5 53.3 21.