FeedbackTuberculosis (TB) is a preventable and curable disease, but it continues to impact the lives and development of millions of children and adolescents. Children and young adolescents aged under 15 years represent about 11% of all TB cases globally. This means 1.1 million children and young adolescents aged under 15 years fall ill with TB every year (1).
National tuberculosis programmes (NTPs) notify less than half of these children, and there is a large case detection gap of children who are not diagnosed and/or not reported. The gap is largest in children aged under 5 years. Reasons for this gap include challenges with specimen collection and bacteriological confirmation of TB in young children due to the paucibacillary nature of TB in this age group and the lack of highly sensitive point-of-care diagnostic tests. Children and adolescents usually access primary health care (PHC) or child health services, where capacity to recognize presumptive TB and access to diagnostic services are limited. In addition to the case detection gap, only a third of child contacts aged under 5 years eligible for tuberculosis preventive treatment (TPT) actually received it in 2020 (1).
TB is also common in adolescents, especially older adolescents aged 15–19 years, with an estimated half a million cases globally each year (2). TB has a major impact on the health and well-being of adolescents. Unlike young children, adolescents are an important risk group for transmission due to infectiousness of disease and high social mobility.
This operational handbook is published alongside the WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents (3), which include the latest evidence-based recommendations related to the prevention and management of TB in children and adolescents.
Surveillance data traditionally refer to children as people aged under 15 years, but the populations of interest in the consolidated guidelines and operational handbook are defined as follows:
• A child is a person aged under 10 years.
• An adolescent is a person aged 10–19 years (inclusive).