bubbles child bubbles

The DECIDE TB Project
– Description –

2 July 2023

Validation of treatment decision algorithms for childhood tuberculosis (TB)
at low levels of healthcare in high burden countries

Effectiveness, implementation & integration into policy
and practices

The Decide TB project will contribute to improve the diagnosis of tuberculosis among children by generating evidence for the implementation of a comprehensive TDA-based approach to tuberculosis treatment in children in high-burden, resource-limited countries at the district hospital and primary health centre levels or a less technical statement.

It started on 1 April 2023 and it will be implemented from 2024 in 2 sub-Saharan Africa countries: Mozambique & Zambia. It is funded by the European Union


WHO has identified that improvement in TB diagnostics
is the highest research priority in the field of child TB

In the absence of highly sensitive microbiological
diagnostic tool for TB in children,…

…Treatment decision algorithms (TDAs)
can help clinicians make rapid
and uniform treatment decision-making,…

…particularly at primary health center (PHC)
and district hospital (DH) levels
for decentralized childhood TB services.

WHO suggested two specific TDAs for use with and without
chest X-ray, with a single diagnostic approach in both the general
paediatric population and high-risk groups (age <2, living
with HIV-CLHIV, or severe acute malnutrition-SAM)

A comprehensive TB TDA-based approach could integrate other
specific TDAs developed for CLHIV and those with SAM
(as developed within the TB-Speed project) if they outperform and
adapt to the needs and existing clinical practices of HCWs
at PHC & DH level.

Scientific questions Decide TB
will aim to answer

How acceptable
are TDAs to HCWs?

What are the key challenges
of implementing TDAs
within routine services
at low levels of care?

Are TDAs effective
in improving the identification
of TB among children?

What are
the costs associated
with the deployment of TDAs?

In this context, the GENERAL OBJECTIVE of the Decide-TB project is:

. to generate evidence for the implementation of a comprehensive TDA-based approach for TB in children living at DH and PHC levels,

. to facilitate integration of this evidence within practices and policies.


European Commission
Université de Bordeaux, France
University of Zambia
Instituto Nacional de Saude, Mozambique
Institut de Recherche pour le Développement, France
Stellenbosh University, South Africa
University of Sheffield, United Kingdom
Ludwig Maximilians Universitat, Munchen, Germany
National TB Program, Mozambique
National TB Program, Zambia
Eduardo Mondlane University, Mozambique
Imperial College London, United Kingdom
Adera, France


April 1st, 2023: Start of Decide TB Project
April 5-6, 2023: Kick-off meeting (videoconference)
June 12-15, 2023: International Workshop (Cape Town) with all partners & countries
July 18-20, 2023: Clinical Workshop in Zambia
July 25-27, 2023: Clinical Workshop in Mozambique
September 2023: Decide TB Website launch


Nicolas KOSKAS
Communication officer – University of Bordeaux