Acknowledgements

The production and writing of the WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents, 2022 was coordinated by Sabine Verkuijl, Annemieke Brands, Kerri Viney and Tiziana Masini, under the guidance of Farai Mavhunga, head of the TB Vulnerable Populations, Communities and Comorbidities unit and the overall direction of Tereza Kasaeva, Director of the World Health Organization (WHO) Global Tuberculosis (TB) Programme. Colleagues from the Prevention, Diagnosis, Treatment, Care and Innovation Unit, Global TB Programme, WHO, under the leadership of Matteo Zignol, also contributed to these guidelines. The WHO Global Tuberculosis Programme gratefully acknowledges the contribution of all experts involved in the development of these guidelines.¹

Guideline Development Group

The Guideline Development Group (GDG) was composed of Susan Abdel-Rahman (Children’s Mercy Research Institute, United States of America (United States)), Deepak Agrawal (Aarogyam Paediatrics Hospital, India), Shakil Ahmed (Dhaka Medical College, Bangladesh), Elie Akl (American University of Beirut and Center for Systematic Reviews of Health Policy and Systems Research, Lebanon), Valentina Aksenova (Research Institute of Phthisiopulmonology of the First M.I. Sechenov Moscow State Medical University, Russian Federation), Farhana Amanullah (Indus Hospital, Pakistan), Grace Bolie (National TB Programme, Democratic Republic of the Congo), Chishala Chabala (University Teaching Hospital, Zambia), Gunta Dravniece (PATH, Ukraine), Connie Erkens (KNCV Tuberculosis Foundation, Netherlands), Betina Mendez Alcântara Gabardo (Clinical Hospital Federal University of Paraná, Brazil), Stephen Graham (University of Melbourne, Australia), Patrik Hummel (Friederich-Alexander University, Germany), Amir M. Khan (Association for Social Development, Pakistan), Margaret Nasil Kal (National TB Programme, Papua New Guinea), Tamara Kredo (South African Cochrane Centre, South African Medical Research Council, South Africa), Susan Maloney (Centers for Disease Control and Prevention, United States), Anna Mandalakas (Baylor College of Medicine; Texas Children’s Hospital, United States), Sushant Mane (Grant Government Medical College and Sir J.J. Group of Hospitals, India), Lindsay McKenna (Treatment Action Group, United States), Imran Pambudi (National TB Programme, Indonesia), Phan Huu Phuc (National Paediatric Hospital, Vietnam), Moorine Sekadde (National TB and Leprosy Programme, Uganda), Kathryn Snow (University of Melbourne, Australia) and Sabira Tahseen (National TB Reference Laboratory, Pakistan).

Elie Akl, Farhana Amanullah, Stephen Graham and Tamara Kredo co-chaired the GDG meeting.

External Review Group

The external reviewers for these guidelines were Martina Casenghi (Elizabeth Glaser Pediatric AIDS Foundation, Switzerland), Anthony Enimil (Komfo Anokye Teaching Hospital, Ghana), Malgorzata Grzemska (former WHO staff member, Poland), Catherine Hewison (Médecins Sans Frontières, France), Devan Jaganath (University of California San Francisco, United States), Kobto Ghislain Koura (The International Union Against TB and Lung Disease, France), Celia Martínez de Cuellar (Hospital de Clínicas, Universidad Nacional de Asunción, Paraguay), Ya Diul Mukadi (United States Agency for International Development (USAID), United States), Rahab Mwaniki (Kenya Aids NGOs Consortium (KANCO), Kenya), Marc Nicol (University of Western Australia, Australia), Elizabeth Maleche Obimbo (University of Nairobi, Kenya), Peter Owiti (Wote Youth Development Project, Kenya), Nyan Win Phyo (Civil Society Taskforce; World Vision, Thailand), Ramatoulaye Sall (Independent Consultant, Senegal), Rina Triasih (Universitas Gadyah Mada, Indonesia) and Eric Wobudeya (Mulago National Referral Hospital, Uganda; Makerere University – Johns Hopkins University (MU-JHU) Research Collaboration, Uganda).

Evidence reviewers

The following persons contributed to the reviews and summarized evidence for the guidelines using the Population, Intervention, Comparator and Outcomes (PICO) framework (see section 1.3 for more information about the PICO questions).

PICO question 1 (TB screening in children): Bryan Vonasek (Baylor College of Medicine, United States; University of Wisconsin, United States); Tara Ness, Alexander W Kay, Anna Mandalakas (Baylor College of Medicine, United States); Yemisi Takwoingi (University of Birmingham, United Kingdom of Great Britain and Northern Ireland (United Kingdom)); Susan S van Wyk (Stellenbosch University, South Africa); Laura Ouellette (Texas Medical Center Library, United States); Ben J Marais (Marie Bashir Institute for Infectious Diseases; University of Sydney, Australia); Karen R Steingart (Liverpool School of Tropical Medicine, United Kingdom).

PICO question 2a (Integrated treatment decision algorithms to diagnose pulmonary TB): Ted Cohen and Kenneth S Gunasekera (Yale School of Public Health, United States); James A Seddon (Imperial College London, United Kingdom; Stellenbosch University, South Africa).

PICO question 2b (Use of Xpert Ultra in gastric aspirate or stool to diagnose pulmonary TB and rifampicin resistance): Alexander W Kay and Tara Ness (Baylor College of Medicine, United States); Yemisi Takwoingi (University of Birmingham, United Kingdom), Karen R Steingart (Liverpool School of Tropical Medicine, United Kingdom).

PICO question 3 (Treatment shortening in children and adolescents with non-severe drug-susceptible TB): Anna Turkova, Genevieve H Wills, Louise Choo, Krissy LeBeau, Margaret J Thomason, Angela M Crook, Diana M Gibb (University College London, United Kingdom); Chishala Chabala (University Teaching Hospital, Zambia), Helen McIlleron (University of Cape Town, South Africa), Paul Revill, James Love-Koh (University of York, United Kingdom), Graeme Hoddinott (Stellenbosch University, South Africa), Hayley Jones (University of Bristol, United Kingdom).

PICO question 4a and 4b (Use of bedaquiline and delamanid in children with MDR/RR-TB, aged below 6 years (bedaquiline) and below 3 years (delamanid)): Pharmacokinetic (PK) and safety analysis: Susan M. Abdel-Rahman (Children’s Mercy Research Institute, United States); Paediatric drug-resistant (DR)-TB individual patient dataset (IPD): Anthony Garcia-Prats (Stellenbosch University, South Africa; University of Wisconsin, United States); Vivian Cox, Rory Dunbar, Tina Sachs, Jessica Workman, Rose Brown, Anneke C. Hesseling (Stellenbosch University, South Africa); Maria Garcia-Cremades, Kendra Radtke, Alexander Floren, Rada Savic (University of California San Francisco, United States), Tamara Kredo, Funeka Bango (South African Medical Research Council, South Africa).

PICO question 5 (Treatment of TB meningitis in children and adolescents): Giorgia Sulis (McGill University, Canada), Gamuchirai Tavaziva, Andrea Benedetti and Faiz Ahmad Khan (McGill University, Canada), Geneviève Gore (McGill University, Canada), Regan Solomons and Ronald van Toorn (Stellenbosch University, South Africa), Stephanie Thee (Charité-Universitätsmedizin Berlin, Germany), Jeremy Day (University of Oxford, United Kingdom), Silvia S Chiang (Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States).

PICO question 6 (Models of care for TB case detection and TB prevention in high TB burden settings): Yael Hirsch-Moverman (Columbia University, United States), Hamidah Hussain (Interactive Research and Development (IRD) Global, Singapore), Daria Szkwarko (Brown University, United States), Courtney Yuen (Harvard Medical School, United States).

Background question 1 (Socioeconomic impact of TB on affected families): Salla Atkins (Karolinska Institutet, Sweden; Tampere University, Finland), Kristi Sidney-Annerstedt and Knut Lönnroth (Karolinska Institutet, Sweden), Lauri Heimo, Maria Ribas Closa (Tampere University, Finland), Lieve Vanleeuw (South African Medical Research Council, South Africa), Peter Wambi (Uganda Tuberculosis Implementation Research Consortium, Uganda), Louisa Chenciner (Royal Free London NHS Foundation Trust, United Kingdom), Uzochukwu Egere (Liverpool School of Tropical Medicine, United Kingdom), Daniel J Carter and Delia Boccia (London School of Hygiene and Tropical Medicine, United Kingdom), Tom Wingfield (Liverpool School of Tropical Medicine, United Kingdom; Liverpool University Hospital NHS Foundation Trust, United Kingdom; Karolinska Institutet, Sweden). (Patient cost surveys): Nobuyuki Nishikiori (WHO, Switzerland).

Background question 2 (Engaging adolescents with TB, or at risk of TB, in their care): Silvia S. Chiang (Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States), Patricia Moscibrodzki (London School of Hygiene and Tropical Medicine, United Kingdom), Leslie A Enane (Indiana University School of Medicine, United States). Contributors: Margaux Amara, Meredith B Brooks, Virginia Byron, Jennifer Furin (Harvard Medical School, United States), Sarah Bernays (University of Sydney, Australia; London School of Hygiene and Tropical Medicine, United Kingdom), Yaroslava Bondarenko (Bogomolets National Medical University, Ukraine), Márcia Cortez Bellotti de Oliveria (Universidade Federal do Rio de Janeiro, Brazil), Andrea T. Cruz (Baylor College of Medicine, United States), Hernán Del Castillo Barrientos (Instituto Nacional de Salud del Niño-Breña, Peru), Anthony Enimil (Kwame Nkrumah University of Science and Technology, Ghana; Komfo Anokye Teaching Hospital, Ghana), Vivian Faith (Network of TB Champions in Kenya, Kenya), Gabriella Ferlazzo (Médecins Sans Frontières, South Africa), Rashida Abbas Ferrand (Rhode Island Hospital, United States; Biomedical Research and Training Institute, Zimbabwe), Graeme Hoddinott (Stellenbosch University, South Africa), Petros Isaakidis (Médecins Sans Frontières, South Africa), Evgenia Karayeva (Brown School of Public Health, United States), Katharina Kranzer (Rhode Island Hospital, United States; Biomedical Research and Training Institute, Zimbabwe), Homa Mansoor (Médecins Sans Frontières, India), Ben J Marais (Marie Bashir Institute for Infectious Diseases; University of Sydney, Australia), Lily Meyersohn (Rhode Island Hospital, United States), Victoria Oliva Rapoport (Alpert Medical School of Brown University, United States), Erika Mohr-Holland (Médecins Sans Frontières, South Africa), Anh Phuong Nguyen (TB Patients Community of Vietnam, Hanoi, Vietnam), Joshua Ochieng Oliyo (Committee of African Youth Advisors, Kenya), Clemax Couto Sant’Anna (Universidade Federal do Rio de Janeiro, Brazil), Saning’o Saruni (Haydom Lutheran Hospital, Tanzania), Susan M Sawyer (Royal Children’s Hospital and Murdoch Children’s Research Institute, Australia; University of Melbourne, Australia), H. Simon Schaaf (Stellenbosch University, South Africa), James A Seddon (Imperial College London, United Kingdom; Stellenbosch University, South Africa), Sangeeta Sharma (National Institute of Tuberculosis and Respiratory Diseases, India), Alena Skrahina (The Republican Research and Practica Centre for Pulmonology and TB, Belarus), Jeffrey R Starke (Baylor College of Medicine, United States), Tania A Thomas (University of Virginia, United States), Rina Triasih (Universitas Gadjah Mada and Dr Sardjito Hospital, Indonesia), Bazarragchaa Tsogt (Mongolian Tuberculosis Coalition, Mongolia), Henry Welch (Baylor College of Medicine, United States; The University of Papua New Guinea, Papua New Guinea), Olga Zvonareva (Maastricht University, the Netherlands).

Evidence reviewers for contextual factors: Olivier Marcy (Université de Bordeaux, France); Maryline Bonnet and Manon Lounnas (Institut de Recherche pour le Développement, France), Eric Wobudeya (Mulago National Referral Hospital, Uganda; Makerere University – Johns Hopkins University (MU-JHU) Research Collaboration, Uganda); Pamela Nabeta (FIND, Switzerland), Claudia M Denkinger and Mary Gaeddert (University of Heidelberg, Germany); Sushant Mukherjee, Mario JP Songane, JeanFrançois Lemaire and Martina Casenghi (Elizabeth Glaser Pediatric AIDS Foundation, Switzerland); Nyashadzaishe Mafirakureva and Peter J Dodd (University of Sheffield, United Kingdom); Nancy Medley and Melissa Taylor (Liverpool School of Tropical Medicine, United Kingdom), Susanna S van Wyk (Stellenbosch University, South Africa), Sandy Oliver (University College London, United Kingdom; and University of Johannesburg, South Africa), Joanna Orne-Gliemann (Université de Bordeaux, France).

WHO Steering Group

The WHO guidelines Steering Group comprised Annabel Baddeley, Lice Gonzalez Angulo, Ernesto Jaramillo, Avinash Kanchar, Charalambos Sismanidis (WHO Global Tuberculosis Programme); Martina Penazzato (WHO Global HIV, Hepatitis and Sexually Transmitted Infections Programme); Bernadette Cappello, Lorenzo Moja (WHO Department of Health Products, Policy and Standards); Marie Valentin (WHO Department of Regulation and Prequalification); Corinne Simone Collette Merle (WHO Special Programme for Research and Training in Tropical Diseases); Valentina Baltag, Wilson Milton Were (WHO Department of Maternal, Newborn, Child & Adolescent Health & Ageing); Lina Mahy (WHO Department of Nutrition and Food Safety); Chiara Servili (WHO Department of Mental Health and Substance Use); Sarah Rylance (WHO Department of Non Communicable Diseases Management); Ogtay Gozalov (WHO Regional Office for Europe); Mukta Sharma (WHO Regional Office for SouthEast Asia); Kyung Hyun Oh (WHO Regional Office for the Western Pacific Region); Pedro Avedillo (Pan American Health Organization); Kenza Bennani, Martin van den Boom (WHO Regional Office for the Eastern Mediterranean Region); André Ndongosieme (WHO Regional Office for Africa).

Other contributors

Pete Dodd (Sheffield University, United Kingdom), Anneke Hesseling (Stellenbosch University, South Africa), Oliver Marcy (University of Bordeaux, France), Nicole Salazar-Austin (Johns Hopkins University, United States), James Seddon (Imperial College London, England) served as technical resource persons during the GDG meeting.

The following persons participated as observers during the GDG meeting: Draurio Barreira Cravo Neto (Unitaid, Switzerland), Charlotte Colvin (USAID, United States), Anne Detjen (UNICEF, United States), Thomas Gradel (Unitaid, Switzerland), Brian Kaiser (Stop TB Partnership Global Drug Facility, Switzerland), Michael McCaul (Stellenbosch University, South Africa), Lawrence Mbuagbaw (St Joseph’s Healthcare, Canada), Celeste Naude (Stellenbosch University, South Africa), Oxana Rucsineanu (TB Community Advisory Board), Anna Scardigli (Global Fund to Fight AIDS, Tuberculosis and Malaria, Switzerland), Cherise Scott (Unitaid).

The Global Tuberculosis Programme also thanks the WHO Guidelines Review Committee for their review and approval of the guidelines.

Funder

This update was funded by grants provided to WHO by Unitaid and the United States Agency for International Development.

¹ For more information about the areas of expertise, the gender and geographical distribution of participants as well as declarations of interests and the management of potential conflicts for members of the GDG and External Review Group, see Web annex 1.

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