Clinical Practice Guidelines for the evaluation, treatment and follow up of children who are contacts of patients with tuberculosis in Colombia
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Introduction: The available Clinical practice guidelines (CPGs) on latent TB infection (LTBI) are not exclusive to the pediatric population.
Objective: To develop evidence-based recommendations for the evaluation, treatment, and follow-up of children in contact with patients with pulmonary tuberculosis (TB) in Colombia.
Methods: A multidisciplinary development group (composed by clinical and field experts, researchers, and methodologists), including patient representatives and decision-makers formulated 10 questions and prioritized outcomes related to diagnosis (clinical evaluation, chest X-ray, and interferon-gamma release assays-IGRA), treatment (efficacy of regimens in different clinical scenarios), and follow-up (monitoring and strategies to increase adherence) for children with LTBI. We conducted systematic reviews of the literature to identify guidelines, systematic reviews, and primary studies. We assessed the quality and risk of bias of these sources using specific tools. We synthesized the evidence narratively and, in some cases, performed de novo meta-analyses (diagnostics and network meta-analyses). We evaluated the certainty of evidence using the GRADE system. We used the GRADE evidence-to-recommendation framework to formulate the recommendations
Results: We recommends the use of chest X-rays and IGRA tests in children in contact to identify active TB. We recommend short instead of long regimens for children with and without immunosuppression and susceptibility-guided regimens in cases of contact with drug-resistant TB. We recommend monthly clinical follow-up and the implementation of comprehensive approaches to identify barriers to encourage treatment adherence
Conclusions: The group provides context-specific evidence-based recommendations for children with LTBI in Colombia
- latent tuberculosis
- Mycobacterium tuberculosis
- prevention
- isoniazida
- rifapentine
- HIV
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Ministerio de Ciencia, Tecnología e Innovación,Departamento Administrativo de Ciencia, Tecnología e Innovación (COLCIENCIAS)
Grant numbers Convocatoria 842-2019 para presentar programas de investigación en temáticas priorizadas en ciencias del Programa Nacional de Ciencia, Tecnología e Innovación en Salud, contrato del programa 902-2019, con el código de registro del proyecto 68743
Accepted 2025-04-11
Published 2025-03-30
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