Clinical standards for drug-susceptible TB in children and adolescents

• Autores: Chiang, S. S., Graham, S. M., Schaaf, H. S., Marais, B. J., Sant’Anna, C. C., Sharma, S., Starke, J. R., Triasih, R., Achar, J., Amanullah, F., Armitage, L. Y., Aurilio, R. B., Buck, W. C., Centis, R., Chabala, C., Cruz, A. T., Demers, A. M., du Preez, K., Enimil, A., Furin, J., Garcia-Prats, A. J., Gonzalez, N. E., Hoddinott, G., Isaakidis, P., Jaganath, D., Kabra, S. K., Kampmann, B., Kay, A., Kitai, I., Lopez-Varela, E., Maleche-Obimbo, E., Mestanza Malaspina, F., Niederbacher Velásquez, J., Nuttall, J. J.C., Oliwa, J. N., Orozco Andrade, I., Perez-Velez, C. M., Rabie, H., Seddon, J. A., Sekadde, M. P., Shen, A., Skrahina, A., Soriano-Arandes, A., Steenhoff, A. P., Tebruegge, M., Tovar, M. A., Tsogt, B., van der Zalm, M. M., Welch, H., Migliori, G. B.
• Formato: artículo
• Fecha de Publicación: 2023
• Institución: Universidad Peruana de Ciencias Aplicadas
• Repositorio: UPC-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorioacademico.upc.edu.pe:10757/669047
• Enlace del recurso: http://hdl.handle.net/10757/669047
• Nivel de acceso: acceso abierto
• Materia: diagnosis; HIV; meningeal tuberculosis; miliary tuberculosis; treatment; tuberculosis infection; Pediatric Tuberculosis (TB); Delphi Consensus Process; Age-Specific Considerations; Microbiological Confirmation; Urgent Treatment (TB Meningitis, Disseminated TB); Weight-Based Regimen; TB Infection Prevention; Home-Based/Community-Based Treatment; Age-Appropriate Support; Case Reporting and Contact Tracing

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.