Operational Handbooks

Based on modelling estimates, between 25 000 and 32 000 children and young adolescents aged under 15 years develop MDR-TB disease annually (110). When treated, outcomes of children with MDR/RR-TB are good, with favourable outcomes in 78% (111) and over 90% in some cohorts (112). Despite these good outcomes, relatively few children are diagnosed and treated for MDR/RR-TB each year, with only 12 220 starting treatment between 2018 and 2020 (11% of the United Nations General Assembly High-level Meeting target of 115 000) (1, 9).

1. Global tuberculosis report 2021. Geneva: World Health Organization; 2021 (https://apps.who.int/iris/handle/10665/346387, accessed 1 December 2021).
2. Snow KJ, Sismanidis C, Denholm J, et al. The incidence of tuberculosis among adolescents and young adults: a global estimate. Eur Respir J. 2018;51(2):1702352.
3. WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents.

The approach to designing MDR/RR-TB treatment regimens is largely the same for all children and adolescents, regardless of HIV status, although potential drug–drug interactions should be avoided through the careful selection of TB medicines in the regimen.¹⁹

When preparing a budget for PMTPT, for example as part of a National Strategic Plan, it is important to conduct systematic costing. The TB module of the integrated health tool for planning and costing is designed to support national strategic health planning over the medium term (1). The WHO costing guidelines for tuberculosis interventions explain how to cost TB interventions from the perspective of the providers of health services and include tools for data collection (2). Listed below are key items that require costing when developing a budget for PMTPT.