Operational Handbooks

^{Note: these developmental assessment tools have not been formally adapted for use in low- and middle-income countries, and locally determined norms have not been developed. Interpretation of results requires careful consideration of the local context. A number of in-country locally developed screening tools are also available.}

• Dosing guidance is based on currently available data and may be revised once additional data are available.
• For patients weighing ≥46 kg, please refer to Table A in Annex 1 of the WHO operational handbook on tuberculosis.

Methodology for developing the treatment decision algorithms

This annex provides examples of standard operating procedures for the most common methods of obtaining clinical samples from children for rapid molecular testing: expectoration, gastric aspiration, nasopharyngeal aspiration (NPA) and sputum induction. 

This annex provides an overview of respiratory and non-respiratory specimens that can be used to diagnose TB in children and adolescents, with a short description for each, the age group in which they can be used, the minimum volume required for testing, and the optimal time of collection.

Roadmap

Roadmap towards ending TB in children and adolescents, second edition. Geneva: World Health Organization; 2018 (https://apps.who.int/iris/bitstream/handle/10665/275422/9789241514798-eng.
pdf?sequence=1&isAllowed=y).

WHO operational handbooks

WHO operational handbook on tuberculosis. Module 1: prevention – tuberculosis preventive treatment. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/9789240002906).

WHO provides guidance on the principles²⁹ and recommendations for nutritional care and support of people with TB as part of their regular TB care.

Five guiding principles are key for providing nutritional care and support as an integral part of TB care and prevention (105):

Children and adolescents with TB disease frequently present with failure to thrive or weight loss (see Chapter 4). Severe malnutrition is one of the key risk factors for TB in children. Children receiving therapeutic nutritional treatment or nutritional supplementation but still not gaining weight, or continuing to lose weight, should be considered as having a chronic disease such as TB and evaluated accordingly (6).

As part of the review for the background question on adolescents, a group of experts was convened to propose actions for optimizing adolescent engagement in TB care. The proposed actions focused on two areas: reforming current practices that are harmful to adolescents with TB; and developing an adolescent-specific plan within each NTP to provide high-quality adolescent-centred TB services.
Box 7.6 summarizes the proposed interventions.