Guidance for national tuberculosis programmes on the management of tuberculosis in children

    Año de publicación: 2014

    This Guideline outlines the purpose and the target audience of the second edition of Guidance for national tuberculosis programmes on the management of tuberculosis in children. It discusses the difference between TB in children and adolescents and TB in adults and provides an estimate of the burden of childhood TB. Important recent changes or additions to guidelines for the management of tuberculosis (TB) in children have made it necessary to revise the first edition of Guidance for national tuberculosis programmes on the management of tuberculosis in children, published by WHO in 2006. Like the 2006 guidance, this document is targeted at national TB programmes, paediatricians and other health workers in low- and middle-income countries; it does not aim to outline recommendations for high-income countries with low TB prevalence. This distinction is especially important in the diagnostic approach and in contact investigation. Current and consistent guidance is important in the development and implementation of policy and practice for improving the management of children with TB and of children living in families with TB. Children are increasingly recognized as important in the widening global Stop TB Strategy, launched in 2006, revised in 2012 and now being revised for beyond 2015. This summary lists the recommendations of the second edition of the guidance and highlights the key changes since the 2006 (first) edition. The chapters that follow the summary provide comprehensive details on the WHO-recommended approaches to prevention, diagnosis and treatment. Updated literature searches were performed and new data were integrated with the existing evidence for all recommendations. During the development of this guidance, the Panel made strong recommendations, based on low or very low quality of evidence given that children are rarely included in TB clinical trials and experience disproportionate suffering as a result of limited detection and treatment. Despite the limited evidence showing a direct benefit to children, the Panel felt confident that existing clinical data from adults could be safely extrapolated to children, and that the individual and public health benefit of treating children with TB far outweigh any potential negative consequences. Panel considerations and decisions for each individual recommendation are included in Annex 1.

    Más Relacionados