Variation in policy and practice of adolescent tuberculosis management in the WHO European Region

Tuberculosis (TB) is a major public health concern worldwide. The World Health Organization (WHO) estimates that 9.6 million people fell ill with TB and 1.5 million people died of TB in 2014. Of an estimated total of 1 million children with TB, 140 000 children died [1]. The risk of progression to TB is highest for children <5 years of age. There is a comparatively low risk for those 5–10 years of age, after which the risk of progression to TB increases at the onset of puberty to an adult level of 5–10% [2] as well as the chance of developing an adult-type TB accompanied by increased infectiousness [3]. However, adolescents form a particularly vulnerable group with psychosocial challenges distinct from adults and the usual challenges of transition from paediatric to adult health service provision. Puberty may affect health behaviour and have a significant impact on therapy compliance [4], requiring specific approaches usually not provided by paediatric or adult health services [5]. Guidelines specifically addressing adolescent tuberculosis are needed for uniform and evidence-based management