A scoping review of interventions in childhood tuberculosis prevention and treatment.

OBJECTIVE

This scoping review aims to identify and map the available evidence on interventions for the prevention and treatment of childhood TB, confirm current practice, explore variation, and identify emerging approaches.

STUDY

DESIGN

Scoping review.

METHOD: This scoping review was conducted using established methods and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The protocol was registered with the Open Science Framework. Selection criteria were defined using the PCC framework, including population (children aged 0-18 years), concept (prevention and treatment of tuberculosis), and context (global settings). Studies with control groups were included, such as randomised controlled trials (RCTs), quasi-experimental studies, cohort studies, case-control studies, and cross-sectional studies. Electronic databases (PubMed, Web of Science, Scopus, Cochrane Library, and EMBASE) and websites of global health agencies (e.g., USAID, UNICEF, WHO, and CDC) were searched.

RESULTS

Following a comprehensive search and screening process, 41 studies were included. Of these, 15 were conducted in the African region (with South Africa contributing the most, n = 7), followed by Southeast Asia (n = 12), Europe (n = 6), the Western Pacific (n = 4), the Eastern Mediterranean (Pakistan, n = 2), the Americas (USA, n = 1), and one multi-country study. Eighteen studies focused on TB prevention, 22 on treatment, and one on both. The review found that combining pharmaceutical and non-pharmaceutical interventions improved prevention outcomes, with treatment completion rates reaching up to 99% and reductions in mortality. The BCG vaccine showed variable efficacy (22-92%), with over 70% protection against TB meningitis reported in several regions. Treatment success rates for drug-sensitive TB reached up to 97%. New regimens incorporating bedaquiline and delamanid for multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB) showed cure rates as high as 94.6%.

CONCLUSION

Overall, shorter treatment regimens were associated with higher completion rates, although evidence on long-term cure remains limited.