Consolidated Guidelines

This chapter includes current WHO recommendations that apply to children and adolescents on TB prevention. They have been consolidated from current WHO guidelines on TB infection, prevention and control, a BCG position paper and guidelines on TPT, namely the WHO guidelines on tuberculosis infection prevention and control, 2019 update (12), the BCG vaccines: WHO position paper (published in the Weekly Epidemiological Record) (13) and the WHO consolidated guidelines on tuberculosis. Module 1: prevention - tuberculosis preventive treatment (14).

This chapter includes current WHO recommendations that apply to children and adolescents on TB screening and contact investigation. They have been consolidated from current WHO guidelines on systematic screening for TB disease and contact investigation, namely the WHO consolidated guidelines on tuberculosis. Module 2: screening - systematic screening for tuberculosis disease (11) and Guidance for national tuberculosis programmes on the management of tuberculosis in children (second edition) (8).

A summary of the structure of the guidelines including a brief description of the contents is provided in Box 1.

The electronic version of the consolidated guidelines on the management of TB in children and adolescents will form part of the WHO TB KS , which features the following components for each TB module: (i) consolidated guidelines, (ii) operational handbooks with implementation guidance; as well as (iii) a catalogue of WHO e-learning materials.

The 2022 consolidated guidelines represent a significant update compared to the previous guidelines issued in 2014. They include: (i) new recommendations based on the review of newly available evidence related to the Population, Intervention, Comparator and Outcomes (PICO) questions that were developed for this guideline update; (ii) recommendations with relevance to children and adolescents from other WHO TB guidelines issued since 2014; and (iii) a few recommendations from the 2014 guidance that remain unchanged.

The target audience for these consolidated guidelines consists primarily of NTPs, primary health care (PHC) programmes, maternal and child health programmes, national AIDS programmes (or their equivalents in health ministries) and other health policy-makers. They also target generalist and specialist paediatricians, clinicians and health practitioners working on TB, HIV and/or infectious diseases in public and private sectors, the educational sector, nongovernmental, civil society and community-based organizations, as well as technical and implementing partners.

The objectives of the 2022 consolidated guidelines on the management of TB in children and adolescents are to:

Since the publication of the WHO Guidance for national tuberculosis programmes on the management of tuberculosis in children (second edition) (2014) (8),there have been numerous studies, including reviews, randomized controlled trials, observational studies, pharmacokinetic (PK) and pharmacodynamic studies, qualitative research and cost-effectiveness research, which have evaluated the impact of various interventions.

Children and young adolescents (aged below 15 years) represent about 11% of all people with TB globally. This means that close to 1.1 million children become ill with TB every year, almost half of them below five years of age. National TB programmes (NTPs) only notify less than half of these children, meaning that there is a large case detection gap (1).