Awareness of the consequences of TB disease in children and adolescents that go beyond survival and completion of treatment has increased (131, 132). Each child or adolescent on TB treatment should be assigned a mutually exclusive treatment outcome at the end of treatment, but follow-up and care may need to go beyond the conclusion of TB treatment (71). There is also a need to quantify and monitor the burden of morbidity that occurs after TB treatment has been completed (post-TB health). Improved data on post-TB health will increase awareness of the long-term consequences of TB and provide evidence-based interventions to improve post-TB health and to better plan for the care and support of affected children, adolescents and their families (133).
This section provides a summary of the current evidence base and some practical guidance in three key areas of post-TB health for children and adolescents: TBM, post-TB lung disease and osteoarticular TB. These key areas are based on the debilitating aspects of the disease (TBM and osteoarticular TB) or the high incidence of disease in the affected organ in conjunction with the potential long-term impact (PTB).
The overarching approach for the management of post-TB health includes family-centred care with the goal of promoting the health and well-being of children, adolescents and their families. The aim should be to provide home-based care and involve caregivers in rehabilitation processes as much as possible. Nutritional assessment and health-related quality of life should also be part of the assessment of post-TB health.