WHO publishes the latest guidance on TB management in children and adolescents

Geneva, August 27, 2021:

Rapid communication announced by the World Health Organization’s (WHO) Global Tuberculosis Program has made significant updates to the guidance on TB management for children and adolescents. It includes new recommendations on diagnostic options, treatment plans, treatment decision algorithms, and optimal care models for providing TB services in children and adolescents.

“Tuberculosis in children and adolescents has been overlooked for many years. This is reflected in the large gap in access to TB prevention and care. Therefore, thanks to the generation of new evidence, we are suffering from tuberculosis. Or it is encouraging to see an expanding range of diagnosis, treatment, prevention and care options for children and adolescents at risk for tuberculosis, “said Dr. Terezaka Saeva, director of global tuberculosis at WHO. program.

“We call on state officials and stakeholders to continue their commitment to prepare and support the full implementation of the new WHO Recommendations on the Management of Tuberculosis in Children and Adolescents.

Rapid communication highlights important updates, including: Recommendations for the use of Xpert MTB / RIF Ultra in gastric aspirates or fecal specimens as an initial diagnostic test for tuberculosis and detection of rifampicin resistance, pulmonary tuberculosis; under 16 years of use with presumed non-severe drugs For children and adolescents, it is recommended to use a 4-month treatment regimen (2HRZ (E) / 2HR) instead of the standard 6-month regimen (2HRZ (E) / 4HR). -Sensitive tuberculosis.

Children of MDR / RR-TB of all ages: Use bedaquiline as part of all shorter oral bedaquiline-containing regimens (conditionally recommended by WHO in 2020) or as part of longer treatment regimens Recommended. Recommendation of using delamanid as part of a longer treatment plan. These recommendations make it possible to design all oral regimens for children of all ages.

As an alternative to the currently recommended 12-month regimen, 6-month isoniazid, rifampicin, pyrazinamide, and adolescents with microbiologically confirmed or clinically diagnosed tuberculous meningitis. Recommendations for the use of shorter intensive regimens composed of etionamide.

Similarly, a treatment decision algorithm that incorporates WHO-recommended diagnostic tests can be used in children under the age of 10 with signs and symptoms of pulmonary tuberculosis. In addition, in situations where the burden of tuberculosis is high, decentralized, family-centric, integrated services can be implemented to improve the spread of tuberculosis case detection and TB prevention treatment.

Rapid communication provides public and private sector healthcare provider ministries, technology partners, and other stakeholders with important findings and considerations related to the diagnosis, treatment, and care of TB in children and adolescents. , And the purpose is to notify you in turn about changes. To enable planning at the national level prior to the release of updated guidelines and related operational handbooks.

Detailed recommendations include WHO’s Integrated Guidelines for Tuberculosis, Module 5: Comorbidity, Vulnerable Populations, and People-Centered Care, along with a supplemental operational handbook with implementation guidance in the coming months. Will be published within. Recommendations are based on the results of the Guidelines Development Group Meeting. ET Health