WHO public call for data on the management of TB in children and adolescents

24 July 2020, Geneva | WHO is initiating the development of updated guidelines on the management of TB in children and adolescents. The second edition of the Guidance for national tuberculosis programmes on the management of tuberculosis in children was published in 2014. Since then, several recommendations included in this guidance have been updated as part of other WHO guidelines, including recommendations on TB preventive treatment, treatment of drug-resistant TB, rapid diagnostics. An update to the TB screening guidelines is currently in process.

Significant progress has been made in recent years, however, important gaps remain, including related to case detection and prevention of TB in children and adolescents. Therefore, the updated guidelines on the management of TB in children (aged 0 to <10 years) and adolescents (aged 10-19 years) will focus on specific issues related to the management of TB in these age groups that are not covered in other WHO guidelines, and to address critical research gaps for which there has been limited evidence so far.

The target audience will include managers and clinicians working in National TB Programmes as well as in Primary Health Care services and other child health services.

To enable this process and collect available evidence that may potentially contribute to this update, WHO is issuing a public call to provide suitable data, appealing to researchers, national TB programmes, child health programmes, and partners.

The request is for data on the management of TB in children and adolescents with the following specifics:

• Diagnostic approaches in vulnerable children, for example, children with severe pneumonia, HIV, or malnutrition;
• Diagnostic accuracy of automated image reading systems for detecting pulmonary abnormalities consistent with TB in children and adolescents;
• Treatment shortening in children with non-severe TB disease;
• Treatment of drug-susceptible TB in children with or without addition of ethambutol;
• Treatment of children with severe forms of extra-pulmonary TB, for example, TB meningitis, TB pericarditis or osteoarticular TB;
• Treatment of congenital TB and very young infants (aged 0-3 months) with TB disease;
• Treatment of children with drug-resistant TB with all oral regimens;
• Management of post-TB sequelae in children and adolescents
• Family-centred care, including (but not limited to) health education and counselling of caregivers, treatment adherence interventions and palliative care in children
• Models of care for TB prevention, case detection, treatment and care in children and adolescents, including (but not limited to) approaches to implementation of contact investigation; other case finding activities; the role of healthcare workers (clinicians, non-clinicians, community health workers) in promoting TB preventive treatment.

Data requirements

Data from studies that have been published or have not yet been reported but otherwise fulfilling the below criteria will be considered for inclusion:

• Studies including children and adolescents between the ages of 0-19 years
• Individual level variables, depending on the type of study: country of the study, year the study was conducted, setting of recruitment (i.e. tertiary hospital vs. health centre), age, sex, specimens and diagnostic tests used, type of TB (including bacteriologically confirmed and clinically diagnosed TB, forms of extra-pulmonary TB, drug susceptibility pattern), type of TB treatment, treatment duration, treatment outcome, adverse events, adherence, and co-morbidities/vulnerabilities (for example, pneumonia, malnutrition, HIV)
• Data from TB high burden settings and from different parts of the world
• Ideally, at least 50 participants from the target age groups included in the study
• Final data (published or unpublished) to be available by January 2021 at the latest

Correspondence

Please express your interest to share data to contribute to this guideline update by 31 August 2020. A data sharing agreement will be provided separately.

Please send all electronic correspondence, including enquiries, to the WHO Global TB Programme at: verkuijls@who.int and brandsa@who.int.

Source: WHO