Children and Adolescents

BCG is a live attenuated bacterial vaccine derived from Mycobacterium bovis that was originally isolated in 1902 from a tuberculous cow. BCG has demonstrated significant effectiveness, but protection has not been consistent against all forms of TB in all age groups. BCG has also shown effectiveness in preventing leprosy (caused by Mycobacterium leprae) and Buruli ulcer (caused by Mycobacterium ulcerans) (31).

Children with TBM should preferably be hospitalized for initiation of treatment and close monitoring. Children aged under 2 years with miliary TB should be evaluated for TBM regardless of the presence of CNS symptoms. If these children are not evaluated for TBM for any reason, extension of treatment to 12 months may be considered.

This chapter summarizes the treatment options available for children and adolescents to treat drug-susceptible TB and DR-TB and pulmonary and extrapulmonary forms of TB (including TBM), and considerations related to post-TB health. It includes operational guidance on various new treatment approaches, including a 4-month treatment regimen, and important implementation considerations such as availability of child-friendly formulations and access to all key medicines for the treatment of DR-TB.