Operational Handbooks

Household contacts of people with PTB are a well-recognized group at risk for TB infection and TB disease, including prevalent TB detected at the time of initial contact investigation and incident TB that occurs within the subsequent 2–5 years (15). WHO recommends that household contacts and other close contacts of people with PTB should be systematically screened for TB disease (14). Contact investigation can be implemented at the health facility, in the community or through a combination of these approaches.

The target audience for this handbook includes NTPs and other child health programmes that provide care for children with or at risk of TB, including maternal, newborn, child and adolescent health programmes, HIV services, and PHC programmes. The handbook also targets paediatricians and other health care workers (HCWs) in the public and private sectors, school health services, civil society and community-based organizations, and health care educators.

In preparation for the development of the WHO consolidated guidelines and operational handbook on the management of TB in children and adolescents, a survey was conducted among end-users to:

• collect perspectives on the barriers and facilitators for the implementation of WHO recommendations on the management of TB in children and adolescents;

• understand respondents’ preferences regarding the content and structure of the operational handbook;

• inform dissemination approaches.

The aim of this operational handbook is to provide practical guidance on the implementation of the World Health Organization (WHO) policy recommendations on the prevention and management of TB in children and adolescents under programmatic circumstances and at different levels of the health system.

Children can present with TB disease at any age, but most commonly between the ages of 1 and 4 years in high TB burden settings. Children who develop TB disease usually do so within a year of TB infection. The presentation of TB in children is an indicator of recent and ongoing transmission of Mycobacterium tuberculosis in the community (4).

Tuberculosis (TB) is a preventable and curable disease, but it continues to impact the lives and development of millions of children and adolescents. Children and young adolescents aged under 15 years represent about 11% of all TB cases globally. This means 1.1 million children and young adolescents aged under 15 years fall ill with TB every year (1).

Unless otherwise specified, the terms defined here apply as used in this operational handbook. They may have different meanings in other contexts.

Active (tuberculosis) case-finding: Provider-initiated screening and testing in communities by mobile teams, often using mobile X-ray and rapid molecular tests. The term is sometimes used synonymously with “systematic screening”.