WHO Guidance for management of tuberculosis in children 2014
Guidance for national tuberculosis programmes on the management
of tuberculosis in children.

Preface
The first edition of Guidance for national tuberculosis programmes on the management of
tuberculosis in children was published in 2006. tuberculosis(TB) It resulted in the revision or development of guidelines for child TB management by national TB programmes in many TB-endemic
countries.tuberculosis(TB) Now, however, newly published evidence and new recommendations have made it necessary to update the original 2006 guidance.
Like the original,tuberculosis(TB) this second edition aims to inform the revision of existing national
guidelines and standards for managing TB, many of which include guidance on children.
It includes recommendations, based on the best available evidence, for improving the
management of children with TB and of children living in families with TB. National and
regional TB control programmes may wish to adapt these recommendations according
to local circumstances.
tuberculosis(TB) Since 2006 there has been a welcome increase in the attention being given to the
specific challenges of TB in children and an increased recognition of its importance as a
global public health challenge.tuberculosis(TB) Although most children with TB may not be responsible for widespread transmission of the disease in the community, TB is an important
contributor to maternal and child morbidity and mortality.
tuberculosis(TB) Following publication of the 2006 guidance, many countries developed national policies and strategies to address childhood TB. tuberculosis(TB) Practical implementation of these strategies,however, has not always been achieved.tuberculosis(TB) The challenge now is to address this widespread policy-practice gap by scaling up childhood TB activities in endemic countries.
tuberculosis(TB) This publication contains a number of important changes or additions to the first edition; these are highlighted in the Executive summary.tuberculosis(TB) It also has separate chapters dealing with issues that were covered only in annexes to the first edition (management of TB/HIV in children and of drug-resistant TB in children) and introduces new topics such as
the importance of integrated care.
tuberculosis(TB) Efforts have been made to include the management of tuberculosis in adolescents
whenever relevant.tuberculosis(TB) This is in recognition of the fact that adolescents are a vulnerable group that is not specifically highlighted in current guidelines for the management of
TB.
tuberculosis(TB) Publication of the first edition of this guidance predated the WHO process for the
development of evidence-based guidelines; preparation of the second edition, however,
has adhered to that process. Many current WHO recommendations, already published
in guideline documents for management of TB and HIV, are referred to in this guidance;
any earlier recommendation that has been altered, following review, as regards detail,
strength of recommendation and/or quality of evidence is highlighted.
tuberculosis(TB) There is an urgent need to address the lack of epidemiological data on TB in children in high-burden countries, and for further study of how children with TB differ from adults
in their immunological and pathological response, so that better tools for prevention,
diagnosis and treatment OF tuberculosis(TB) can be developed and evaluated. Nevertheless, there is much that can already be done to reduce the burden of TB in children.

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