Consolidated Guidelines

Acknowledgements

The production and writing of this document – WHO consolidated guidelines on tuberculosis. Module 4: Treatment: Drug-susceptible tuberculosis treatment – was coordinated by Fuad Mirzayev, with the support of Medea Gegia, Linh Nguyen and Kerri Viney, under the guidance of Matteo Zignol, and the overall direction of Tereza Kasaeva, Director of the WHO Global Tuberculosis Programme.

9. References

  1. Global tuberculosis report 2021. Geneva: World Health Organization; 2021 (https://apps.who.int/iris/handle/10665/346387, accessed 1 December 2021).
  2. Marais B. The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis. 2004;8(4):392-402.
  3. Martinez L, Cords O, Horsburgh CR, Andrews JR, Pediatric TB Contact Studies Consortium.

Annex 1. WHO recommendations incorporated in the guidelines on the management of TB in children and adolescents

In order of presentation:

WHO consolidated guidelines on tuberculosis. Module 2: screening - systematic screening for tuberculosis disease. Geneva: World Health Organization; 2021.

Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. Geneva: World Health Organization; 2012.

WHO guidelines on tuberculosis infection prevention and control, 2019 update. Geneva: World Health Organization; 2019.

8. Research priorities

This chapter includes research gaps or priorities that were identified by the GDG members while considering the evidence related to each of the PICO questions. Addressing the identified research gaps has the potential to inform the development of future research questions that can improve TB prevention and care. This list of research priorities is not exhaustive; but it complements the existing research agenda outlined in Research priorities for paediatric tuberculosis (127) and other WHO guidelines.

7. Special situations

This chapter includes valid WHO recommendations that apply to children and adolescents in special situations such as for the management of TB in the context of HIV infection or malnutrition and optimal feeding of infants of mothers infected with TB.

6.1.3. Implementation considerations

Health system requirements: Training of health care workers at peripheral levels of the health system is a critical requirement to ensure adequate implementation of decentralized approaches. Similarly, resources are needed at the peripheral level, especially initially to establish services. It is expected that as services are established and effectively implemented, the long-term impact will result in a decrease in TB incidence with an associated reduction in resource requirements.

6.1.2. Subgroup considerations

Adolescents have a disease presentation that is similar to adults, and therefore may need different interventions than young children. Additional subgroup considerations for adolescents are included in the operational handbook, taking into account their specific health-seeking behaviour and the need for adolescent-friendly services.