Rapid advice: treatment of tuberculosis in children
Publication year: 2010
The World Health Organization (WHO) first published guidance for national
tuberculosis control programmes on managing tuberculosis in children (hereafter
called “the Guidance”) in 2006. The Guidance follows the principles of a public
health approach aimed at optimizing outcomes, including the quality of life and
survival, of children with tuberculosis; it also serves as a reference tool for countries
to adopt and adapt according to their national circumstances.
During 2009 and 2010, WHO updated the Guidance through a series of coordinated
efforts to review and synthesize evidence on the correct dosages of antituberculosis
medicines for use in children and the regimens that should be used for different
manifestations of the disease in children. This evidence was assembled following
systematic reviews, pharmacokinetic simulations and the preparation of evidence
summaries, using GRADE profiles and analysis where appropriate.
There have been major developments in advancing the use of new diagnostic tools,
but these tools are not recommended for the diagnosis of latent tuberculosis infection
or active tuberculosis disease in children. Preventive chemotherapy for children
infected with the human immunodeficiency virus (HIV) will be addressed in other
guidelines published by WHO.
The availability of new evidence, specifically concerning the correct dosages of the
four essential antituberculosis medicines, justified the rapid revision of WHO’s
Guidance.
Representatives of the Stop TB Partnership’s Childhood TB sub-working group who
participated in the Guidelines Group formulated this revised guideline in the format of
a Rapid Advice during a meeting of the Guidelines Group held in March 2010. In
addition, two experts in paediatric pharmacology contributed to the development of
this Rapid Advice.