To more effectively find and treat children with tuberculosis (TB), the document advocates applying a "family-centered approach" which traces cases from child patients to adult contacts and vice versa. This approach involves investigating the household contacts of both children and adults diagnosed with TB as well as investigating the source case to identify additional contacts for preventive treatment or treatment if disease is found.

1. www.sentinel-project.org
Happy 1st birthday!
(Launched 28 Oct 2011) sentinel_project@hms.harvard.edu

2. DR-TB

3. To find and treat more children
with TB, we need to apply widely
a “family-centered approach”…
Prof. Jeff Starke
Baylor College of Medicine
Houston, Texas, USA

4. JOURNAL OF PEDIATRICS 1956

5. Hsu KHK. Contact investigation: A practical
approach to tuberculosis eradication. AJPH 1963.
“Children with TB may be compared to
sensitive Geiger counters…
TB exists today in „pools‟ …
An enormous number of cases of TB are
to be found in these „pools‟…
A dual approach is necessary by which
cases are traced from child patients to
adult contacts, and from adult patients to
child contacts.”

7. Household ?
contact ? ?
investigation
?
?
?

8. Household ?
contact ? ?
investigation
?
?
?

9. Household
contact
investigation

10. Household
contact
investigation

12. Source
case
?
investigation
?
?

13. Source
case
?
investigation
?
?

14. Source
case
investigation

15. Source
case
investigation

16. FAMILY-
CENTERED
APPROACH
Source
case
investigation
Household
contact
investigation

17. FAMILY-
CENTERED
APPROACH
Source
case
investigation
Household
contact
investigation

18. FAMILY-
CENTERED
APPROACH
Source
case
investigation
Household
contact
investigation
Preventive
therapy

19. FAMILY-
CENTERED
APPROACH
Source
case
investigation
Household
contact
investigation
Preventive Treatment
therapy of disease

20. FAMILY-
CENTERED
APPROACH
Source
case
DR-TB
investigation
Household
contact
investigation
DR-TB
Preventive Treatment
therapy of disease