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THINK TANK TREATMENT TOOLS

Paediatric TB Decision Tool

Complete the patient assessment below to generate a recommended next step for children under 10 years.

Patient Assessment

Age of child

Child in contact with adult/adolescent with TB in past 12 months?

TB site in index person

Index person has Pulmonary TB (inside the lungs) Uncertain of TB site in index person Index person has Extra-pulmonary TB (outside the lungs)

Exposure timing

Exposure intensity

Child spent long periods during the day with index person (creche/transport/school/etc.) Child slept in the same room Child had minimal exposure

HIV status

LF-LAM

Child high risk group

Signs and symptoms present

No signs and symptoms present Cough (longer than 2 weeks and fails to improve) Loss of appetite Fatigue / reduced playfulness Failure to thrive Weight loss Fever for more than 2 weeks Drenching night sweats Visible neck swelling / enlarged typical lymph nodes Blood-stained sputum Tachycardia (fast pulse) Tachypnoea (fast breathing) Headache Persistent vomiting without diarrhoea Confusion Irritability Abnormal behaviour Sleepiness / reduced level of consciousness Convulsions Regression of milestones Neck stiffness Bulging fontanelle Weakness on one side Cranial nerve palsies Haemoptysis (coughing blood)

Child seen at

Child severely / acutely malnourished

Completed TPT course previously

Chest X-Ray

TB NAAT results

Recommended Action

Additional Information

About This Tool

This Paediatric TB Decision tool provides structured decision support for children under 10 years by combining key clinical history (TB exposure and intensity), risk factors (including HIV status, malnutrition and high-risk groups), and available investigations (CXR and TB NAAT).

Based on the information entered, it suggests the next best action such as urgent referral/hospital assessment, further diagnostic testing, initiation of treatment when indicated, or preventive care and follow-up. It does not replace clinical judgement; always prioritise emergency stabilisation and local/national TB guidelines.

To download the latest South African National TB guidelines.

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