4.2. Treatment decision algorithms for the diagnosis of pulmonary TB in children aged below 10 years of age

Interim recommendation

In children with presumptive pulmonary TB attending health care facilities, integrated treatment decision algorithms may be used to diagnose pulmonary TB.
(Conditional recommendation, very low certainty of evidence).


  • Presumptive TB refers to a person who presents with symptoms and/or signs suggestive of TB.²⁴
  • Bacteriological confirmation should be sought as part of the integrated treatment decision algorithms whenever possible, using WHO recommended rapid diagnostic tests and appropriate paediatric specimens (including stool, nasopharyngeal aspirate, induced or expectorated sputum or gastric aspirate).
  • In follow-up to the GDG meeting, new integrated treatment decision algorithms for specific populations and settings, have been developed and internally validated. These algorithms are detailed with practical guidance on their use in the operational handbook on the management of tuberculosis in children and adolescents.²⁵ National TB and other health programmes are encouraged to use these evidence-based algorithms.
  • This interim recommendation will remain valid for a period of 24 months after the publication of these guidelines, after which new evidence will be reviewed.

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