Excerpt

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.

Contents

• Acknowledgements
• 1. Overview
  • 1.1 Background
  • 1.2 Why the need for a revision?
  • 1.3 Guiding principles
• 2. Recommendations at a glance
• 3. Revision process
  • 3.1 Retrieving, summarizing and presenting the evidence
  • 3.2 Consensus, external review and updating
  • 3.3 Publication and timing
• 4. Dissemination, adaptation, implementation and evaluation
• 5. Companion documents
• 6. Collaboration with external partners
• 7. Key recommendations
  • Recommendation 1
  • Recommendation 2
  • Recommendation 3
  • Recommendation 4
  • Recommendation 5
  • Recommendation 6
  • Recommendation 7
  • Recommendation 8
  • Recommendation 9
  • Recommendation 10
• 8. Research needs
• 9. Members of the Guidelines Group
• 10. Members of the External Review Group
• 11. Declarations of interest

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