WHO Consolidated Guidelines on Tuberculosis. Module 5: Management of …

World Health Organization (WHO). WHO consolidated guidelines on tuberculosis. Module 5: management of tuberculosis in children and adolescents. Geneva:; 2022. Licence: CC BY-NC-SA 3.0 IGO.

Children and young adolescents (aged below 15 years) represent about 11% of all people with tuberculosis (TB) globally. This means that 1.1 million children become ill with TB every year, almost half of them below five years of age. National TB programmes (NTPs) only notify less than half of these children, meaning that there is a large case detection gap (1). The reasons for this gap include challenges with specimen collection and bacteriological confirmation of TB in young children, due to the paucibacillary nature of TB disease in this age group and the lack of highly sensitive point-of-care tests. In 2020, the COVID-19 pandemic had an additional negative impact on TB notifications in children. In addition to the case detection gap, only one third of child contacts below five years of age eligible for TB preventive treatment (TPT) received it in 2020. Young children are at higher risk of developing TB disease, including severe forms of TB, after TB infection, and the majority do so within a few months following exposure and infection (2, 3). In addition to children and young adolescents, over half a million older adolescents (aged 15–19 years) are estimated to develop TB every year (4).

The United Nations Sustainable Development Goal (SDGs) (5) and the World Health Organization (WHO) End TB Strategy (6) include targets to reduce TB incidence by 80% and TB deaths by 90% to be achieved by the year 2030, relative to baseline levels in 2015. In addition, to accelerate progress towards these global targets, the Resolution adopted by the United Nations General Assembly at the High-Level Meeting on the fight against tuberculosis in September 2018 commits to diagnosing and treating 40 million people with TB (including 3.5 million children), and 1.5 million people with drug-resistant TB (DR-TB) (including 115 000 children) by 2022. It also commits to providing at least 30 million people (including 4 million child contacts under five years of age), 20 million other household contacts (including children aged five years and above) and 6 million people living with HIV (including children) with TPT by 2022 (7).

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