Documents developed by the Childhood TB Subgroup

Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children (Portuguese version)
This document represents consensus guidance developed by the childhood TB subgroup (one of the subgroups of the DOTS Expansion Working Group, under the overall auspices of the Stop TB Partnership). It has been published in a shorter form as a series of papers in the International Journal of TB and Lung Disease:
Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5

Ethambutol efficacy and toxicity:
literature review and recommendations for daily and intermittent dosage in children

This document reviews the published evidence relating to the dosage, toxicity and pharmacokinetics of ethambutol in children and adults and makes a recommendation for a revised daily dose of ethambutol to be used in children. In view of the almost total lack of ocular toxicity in children of all ages receiving ethambutol at doses of from 15-30 mg/kg documented in this review it can be recommended that children of all ages can be given ethambutol in daily doses of 20 mg/kg (range 15-25 mg/kg) and three times weekly intermittent doses of 30 mg/kg body weight without undue concern. The document is also published in a shorter form in the International Journal of TB and Lung Disease:
Donald PR, Maher D, Maritz JS, Qazi S. Ethambutol dosage for the treatment of children: literature review and recommendations. International Journal of Tuberculosis and Lung Disease 10(12):1318-1330

A research agenda for childhood tuberculosis
This document sets out research priorities on childhood TB for national TB control programmes. It has also been published in a shorter form in the International Journal of TB and Lung Disease:
Donald PR, Maher D, Qazi S. A research agenda to promote the management of childhood tuberculosis within national tuberculosis programmes. The International Journal of Tuberculosis and Lung Disease 2007; 11 (4): 370-380. Official Journal of the International Union Against Tuberculosis and Lung Disease.

Other policy documents

Dosing instructions for the use of currently available fixed-dose combination TB medicines for children

The WHO Global Tuberculosis Programme, the Global Drug Facility and the WHO Department of Essential Medicines and Pharmaceutical Policies have issued instructions on how to use the new dosages prescribed for treating TB in children with the existing fixed-dose combinations of TB medicines provided to national TB programmes through GDF.

The new dosages were agreed in 2008 and approved by an Expert Panel on Essential Medicines earlier this year. Making the necessary changes to national guidelines or manuals is a long process, and an interim solution became necessary for supplying users with the right instructions for use of the new evidence-based treatment.

Final report
Interim Paediatric FDCs dosing instructions

Revised BCG policy

Safety of BCG vaccine in HIV-infected children.
Report of Global Advisory Committee on Vaccine Safety, 29-30 November 2007. Weekly Epidemiological Record 2007, 82, 17-24.

Revised BCG vaccination guidelines for infants at risk for HIV infection.
Report of Strategic Advisory Group of Experts, 17-18 April 2007. Weekly Epidemiological Record 2007, 82, 181-196.