When a tuberculosis (TB) outbreak emerged at a San Francisco high school at the end of 2025, the scale was immediately clear. More than 1,200 students required evaluation, with high rates of infection...

YouTube video by UCSF Pediatrics

SUMMARYBACKGROUNDTo improve childhood TB diagnosis, treatment-decision algorithms (TDAs) with and without chest X-ray (CXR) were developed for children under age 10. We aimed to model diagnostic performance and costs of implementing TDAs in primary health centre (PHC) and district hospital (DH) settings in Uganda.METHODSWe developed decision-tree models following the TDA pathway from evaluation to treatment-decision. We compared six scenarios with combinations of diagnostic testing (stool and respiratory Xpert, urine lipoarabinomannan, and/or CXR) at PHCs and DHs. Outcomes were diagnostic accuracy and cost per correct treatment-decision for a cohort of 10,000 children with presumptive TB using a Monte Carlo simulation from a health system perspective. Costs were reported in 2024 international dollars (I$).RESULTSIn all scenarios, TDAs had high sensitivity (80.8%–91.9%) but low specificity (50.9%–60.9%). Total diagnostic and treatment costs for the cohort were I$1,768,958–2,470,298, largely driven by overtreatment of false-positive cases. Diagnostic costs were mostly offset by reducing overtreatment. The cost per treatment-decision was lowest using mobile CXR at PHCs (I$287) and highest with DH referral (I$449).CONCLUSIONThe TDAs have high sensitivity and can be implemented at PHCs with lower costs than DHs. Improving specificity and reducing treatment costs would enable affordable, large-scale implementation.

Computer-aided detection (CAD) systems for automated reading of chest x-rays (CXRs) have been developed and approved for tuberculosis triage in adults but not in children. However, CXR is frequently t...

In this work, through a comprehensive proteomics approach, the authors identified host plasma protein biosignatures that could distinguish tuberculosis (TB) disease in children.

In this work, through a comprehensive proteomics approach, the authors identified host plasma protein biosignatures that could distinguish tuberculosis (TB) disease in children.

Select your preferred language for Cochrane reviews and other content. Sections without translation will be in English.

AbstractBackground. Centrifuge-free processing methods support stool Xpert Ultra testing for childhood tuberculosis (TB), but there are limited data on the

AbstractBackground. Children with non-severe TB may benefit from short-course treatment, but point-of-care tools are needed to stratify disease severity. W

Author summary In this study, we assessed and compared the accuracy of the 2017 Uganda National TB and Leprosy Program (NTLP) algorithm with the 2022 World Health Organization (WHO) Treatment Decision...

This policy brief describes the crucial role NIH plays in supporting research on new products to prevent, diagnose, and cure TB. This research is especially important at a time when new forms of drug ...

A journey through the front lines of global poverty shows that when the world’s richest men slash aid for the world’s poorest children, the result is sickness, starvation and death.

The stop-work order on U.S.A.I.D.-funded research has left thousands of people with experimental drugs and devices in their bodies, with no access to monitoring or care.