Tuberculosis Clinical Practice Guidelines (WHO, 2022)

World Health Organization

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

April 29, 2022

2022 clinical practice guidelines for the management of tuberculosis (TB) in children and adolescents were published online on March 21 by the World Health Organization (WHO) as part of the WHO Consolidated Guidelines on Tuberculosis.

New recommendations include those for diagnostic approaches to TB, a shorter treatment duration for children with non-severe drug-susceptible TB, another treatment option for TB meningitis, the use of bedaquiline and delamanid in young children with multidrug- and rifampicin-resistant TB, and decentralized and family-centered, integrated models of care for case detection and prevention of TB in children and adolescents.

Diagnostic Approaches

  • Rapid molecular tests called Xpert Ultra should be used as the initial test for TB in children and adolescents. Diagnostic testing can now include noninvasive specimens, such as stool samples. (Updated: Strong recommendation)

  • In children with presumptive pulmonary TB being cared for at healthcare facilities, treatment decision algorithms may be used to diagnose pulmonary TB. (NEW: Interim, conditional recommendation)

Treatment Regimens

  • Children with mild TB can be treated with a shorter regimen of 4 months, rather than 6 months. (NEW: Strong recommendation)

  • Two oral medications for drug-resistant TB (bedaquiline and delamanid) are now recommended for use in children of all ages. (NEW: Conditional recommendation)

  • Children and adolescents with bacteriologically confirmed or clinically diagnosed TB meningitis may be treated with a 6-month intensive regimen as an alternative to the 12-month regimen. (NEW: Conditional recommendation)

Models of TB Care

  • In settings with high TB burden, decentralized TB services may be used for children and adolescents with evidence of TB and/or exposure to TB. (NEW: Conditional recommendation)

  • Family-centered, integrated services may be added to standard TB services in children and adolescents with signs and symptoms of TB and/or exposure. (NEW: Conditional recommendation)

For more information, please go to Tuberculosis and Pediatric Tuberculosis.


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