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(2014; 146 pages)
The first edition of Guidance for national tuberculosis programmes on the management of tuberculosis in children was published in 2006. It resulted in the revision or development of guidelines for child TB management by national TB programmes in many TB-endemic countries. Now, however, newly published evidence and new recommendations have made it necessary to update the original 2006 guidance.
Like the original, this second edition aims to inform the revision of existing national guidelines and standards for managing TB, many of which include guidance on children.
It includes recommendations, based on the best available evidence, for improving the management of children with TB and of children living in families with TB. National and regional TB control programmes may wish to adapt these recommendations according to local circumstances.
Since 2006 there has been a welcome increase in the attention being given to the specific challenges of TB in children and an increased recognition of its importance as a global public health challenge. Although most children with TB may not be responsible for widespread transmission of the disease in the community, TB is an important contributor to maternal and child morbidity and mortality.
Following publication of the 2006 guidance, many countries developed national policies and strategies to address childhood TB. Practical implementation of these strategies, however, has not always been achieved. The challenge now is to address this widespread policy-practice gap by scaling up childhood TB activities in endemic countries.
This publication contains a number of important changes or additions to the first edition; these are highlighted in the Executive summary. It also has separate chapters dealing with issues that were covered only in annexes to the first edition (management of TB/ HIV in children and of drug-resistant TB in children) and introduces new topics such as the importance of integrated care.
Efforts have been made to include the management of tuberculosis in adolescents whenever relevant. This is in recognition of the fact that adolescents are a vulnerable group that is not specifically highlighted in current guidelines for the management of TB...