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Clinical standards for drug-susceptible TB in children and adolescents.
- Chiang, S;
- Graham, S;
- Schaaf, H;
- Marais, B;
- SantAnna, C;
- Sharma, S;
- Starke, J;
- Triasih, R;
- Achar, J;
- Amanullah, F;
- Armitage, L;
- Aurilio, R;
- Centis, R;
- Chabala, C;
- Cruz, A;
- Demers, A-M;
- du Preez, K;
- Enimil, A;
- Furin, J;
- Garcia-Prats, A;
- Gonzalez, N;
- Hoddinott, G;
- Isaakidis, P;
- Jaganath, D;
- Kabra, S;
- Kampmann, B;
- Kay, A;
- Kitai, I;
- Lopez-Varela, E;
- Maleche-Obimbo, E;
- Malaspina, F;
- Velásquez, J;
- Nuttall, J;
- Oliwa, J;
- Andrade, I;
- Perez-Velez, C;
- Rabie, H;
- Seddon, J;
- Sekadde, M;
- Shen, A;
- Skrahina, A;
- Soriano-Arandes, A;
- Steenhoff, A;
- Tebruegge, M;
- Tovar, M;
- Tsogt, B;
- van der Zalm, M;
- Welch, H;
- Migliori, G;
- Buck, William
- et al.
Published Web Location
https://doi.org/10.5588/ijtld.23.0085Abstract
BACKGROUND: These clinical standards aim to provide guidance for diagnosis, treatment, and management of drug-susceptible TB in children and adolescents.METHODS: Fifty-two global experts in paediatric TB participated in a Delphi consensus process. After eight rounds of revisions, 51/52 (98%) participants endorsed the final document.RESULTS: Eight standards were identified: Standard 1, Age and developmental stage are critical considerations in the assessment and management of TB; Standard 2, Children and adolescents with symptoms and signs of TB disease should undergo prompt evaluation, and diagnosis and treatment initiation should not depend on microbiological confirmation; Standard 3, Treatment initiation is particularly urgent in children and adolescents with presumptive TB meningitis and disseminated (miliary) TB; Standard 4, Children and adolescents should be treated with an appropriate weight-based regimen; Standard 5, Treating TB infection (TBI) is important to prevent disease; Standard 6, Children and adolescents should receive home-based/community-based treatment support whenever possible; Standard 7, Children, adolescents, and their families should be provided age-appropriate support to optimise engagement in care and clinical outcomes; and Standard 8, Case reporting and contact tracing should be conducted for each child and adolescent.CONCLUSION: These consensus-based clinical standards, which should be adapted to local contexts, will improve the care of children and adolescents affected by TB.
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