FeedbackAfter a clinician has decided to start treatment in a child based on bacteriological testing or as a result of a treatment decision algorithm, the child should be registered with the NTP. This applies to all services and programmes where children and adolescents with TB are diagnosed, including public non-NTP services and private-sector facilities and practitioners. Underreporting of children and adolescents diagnosed with TB in these sectors contributes to the high proportion of missing children and adolescents with TB. Children and adolescents diagnosed with TB in hospitals who die before treatment initiation or discharge should also be registered (5).
Local monitoring of specimen collection by specimen types, diagnostic tests, results and clinical diagnosis in a TB laboratory register (or equivalent) is advised. For countries with case-based electronic recording and reporting systems, all children and adolescents treated for TB should be reported by the NTP in one of four age bands (0–4, 5–9, 10–14 and 15–19 years):
- Record the diagnostic category, treatment regimen and treatment start date on the child’s growth monitoring card, TB treatment card and health unit TB register.
- Record the child’s weight at each visit on their growth monitoring card and TB treatment card (weight is important for monitoring the treatment response and to adjust dosing.)
- Record treatment outcomes on the TB register and report them to the NTP for all children and adolescents.
- Outcome categories for children and adolescents are the same as for adults (108). Of note, few younger children with TB would meet the criteria for “cured” as they are less likely to have bacteriologically confirmed TB. Further, in most settings, children who cannot expectorate are not required to be retested for evidence of a bacteriological response at multiple occasions beyond a 2-month assessment, unless there are other indications of a poor treatment response.