New recommendations in the care of pediatric and adolescent patients with tuberculosis Official opinion of the Children’s Pulmonology Society ČLS JEP and the Society for Pneumology and Phthisiology ČLS JEP
Authors:
Doležalová Karolína 1; Vašáková Koziar Martina 2; Pohunek Petr 3
Authors‘ workplace:
Pediatrická klinika, 1. lékařská fakulta, Univerzita Karlova a Fakultní, Thomayerova nemocnice, Praha
1; Pneumologická klinika, 1. lékařská fakulta, Univerzita Karlova a Fakultní, Thomayerova nemocnice, Praha
2; Pediatrická klinika, 1. lékařská fakulta, Univerzita Karlova a Fakultní, nemocnice Motol, Praha
3
Published in:
Čes-slov Pediat 2024; 79 (Supplementum 1): 25-35.
Category:
doi:
https://doi.org/10.55095/CSPediatrie2024/031
Overview
The new recommendations are a follow-up to the 2012 Standard treatment guidelines(1) and the 2016 special issue of Czech-Slovak Paediatrics dedicated to tuberculosis (TB).(2)
The present document reflects the new recommendations(3) of the World Health Organization (WHO), which has long been seeking new strategies for optimal treatment of paediatric and adolescent patients, as more than 10 million people worldwide develop TB annually, including 1.2 million children.(4) In the Czech Republic, TB remains a rare disease, with an incidence of 3.6/100,000 in 2022.(5) Childhood TB mirrors the trend of adult TB. Between 2010–2020, the trend was downward. Even the change in vaccination strategy in 2010 did not change this trend.(6) From 2021, we observe a slight increase in paediatric TB cases. In 2023, 29 children developed TB (Figure 1).
The increase in paediatric TB cases, including treatment-resistant forms, makes it imperative to update recommendations for diagnosis and treatment in line with global trends. In particular, the main changes to the recommended approach relate to shortening treatment of uncomplicated TB in children aged 3-16 years to 4 months. There are also newly defined groups of drug-resistant (DR) TB and a new strategy for their treatment, which includes the administration of bedaquiline and delamanid. The introduction of TB preventive therapy for contacts of DR-TB is also innovative.
Keywords:
diagnosis – tuberculosis – therapy – resistant forms – treatment strategy
Sources
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2024 Issue Supplementum 1
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