5. Treatment of TB disease in children and adolescents

This chapter contains four new recommendations (published for the first time and described in full detail here) relevant to the treatment of TB disease in children and adolescents as well as other valid WHO recommendations that apply to the treatment of TB in children and adolescents (section 5.4). The four new recommendations concern drug-susceptible TB (DS-TB): (i) a four-month regimen for children and adolescents below 16 years of age with non-severe drug-susceptible TB (section 5.1); (ii) a six-month intensive regimen to treat TBM composed of isoniazid, rifampicin, pyrazinamide and ethionamide (section 5.2); (iii) use of bedaquiline as part of shorter or longer regimens for children of all ages to treat MDR/RR-TB (section 5.3.1); and (iv) use of delamanid as part of longer regimens for children of all ages to treat MDR/RR-TB (section 5.3.2).

The recommendations in this chapter have been consolidated from current WHO guidelines on TB treatment, namely the WHO consolidated guidelines on tuberculosis. Module 4: treatment -drug-susceptible tuberculosis treatment, 2022 update (55) and the WHO consolidated guidelines on tuberculosis. Module 4: treatment - drug-resistant tuberculosis treatment, 2020 update (9). Where appropriate, details on recommendations from the 2014 Guidance for national tuberculosis programmes on the management of tuberculosis in children (second edition) (8), and Rapid advice: treatment of tuberculosis in children (56), which remain relevant have been included. For more information on each recommendation including the remarks, source of evidence, justification, subgroup, implementation and monitoring and evaluation considerations, the source guidelines or WHO TB KSP should be consulted.

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