Consolidated Guidelines

Tuberculosis (TB) infection is a state that is characterized by persistent immune response to stimulation by Mycobacterium tuberculosis (Mtb) antigens with no evidence of clinically manifest TB disease.¹ It is estimated that about a quarter of the world’s population is infected with Mtb. Testing for TB infection increases the probability that individuals who are the target for TB preventive treatment (TPT) will benefit from such treatment. However, there is no gold-standard test to diagnose TB infection.

The recommendations included in these consolidated policy guidelines on tuberculosis (TB) are the result of a collaborative effort among professionals from a range of specialities. The World Health Organization (WHO) is grateful for their time and support.

TB antigen-based skin tests (TBSTs) for the diagnosis of TB infection

GDG meeting on use of TBSTs for the diagnosis of TB infection, Geneva, Switzerland, 31 January–3 February 2022

Guideline Development Group

This chapter includes current WHO recommendations that apply to children and adolescents on TB prevention. They have been consolidated from current WHO guidelines on TB infection, prevention and control, a BCG position paper and guidelines on TPT, namely the WHO guidelines on tuberculosis infection prevention and control, 2019 update (12), the BCG vaccines: WHO position paper (published in the Weekly Epidemiological Record) (13) and the WHO consolidated guidelines on tuberculosis. Module 1: prevention - tuberculosis preventive treatment (14).

Introduction

Children and young adolescents (aged below 15 years) represent about 11% of all people with tuberculosis (TB) globally. This means that 1.1 million children become ill with TB every year, almost half of them below five years of age. National TB programmes (NTPs) only notify less than half of these children, meaning that there is a large case detection gap (1).

Summary of changes to recommendations as included in the second edition of the Guidance for national tuberculosis programmes on the management of tuberculosis in children, 2014

This chapter includes valid WHO recommendations that apply to children and adolescents in special situations such as for the management of TB in the context of HIV infection or malnutrition and optimal feeding of infants of mothers infected with TB.

Table 7: WHO recommendations on models of TB care relevant to children and adolescents

Table 6: WHO recommendations on TB treatment relevant to children and adolescents

Table 5: WHO recommendations on diagnostic approaches relevant to children and adolescents