DECIDE-TB study protocol published in BMJ Open

We are pleased to announce the publication of the DECIDE-TB study protocol in BMJ Open.
The article presents the design and objectives of the DECIDE-TB trial, which evaluates the implementation of WHO-recommended Treatment Decision Algorithms (TDAs) for childhood tuberculosis screening, diagnosis and treatment in Mozambique and Zambia.

Childhood tuberculosis remains a major public health challenge. Each year, many children with TB are not diagnosed or treated in time, contributing to preventable morbidity and mortality. In this context, TDAs provide a structured and scalable approach to support healthcare workers in identifying children who need further evaluation or treatment for TB, particularly in settings where access to diagnostic tools may be limited.

DECIDE-TB is a pragmatic stepped-wedge cluster-randomised trial implemented within national TB programmes in Mozambique and Zambia. It evaluates a comprehensive TDA-based approach combining WHO TDAs A and B, the PAANTHER algorithm for children living with HIV, and the TB-Speed Severe Acute Malnutrition algorithm, supported by a DHIS2-based clinical decision support system.

Beyond effectiveness, the trial also assesses feasibility, acceptability, costs and policy uptake. By generating evidence in real-world programmatic settings, DECIDE-TB aims to inform the integration of TDA-based approaches into national childhood TB strategies.

The publication of the study protocol marks an important milestone for the project and its partners, reflecting the collaborative work carried out across countries and institutions to improve access to timely TB diagnosis and treatment for children.

Read the full Decide TB protocol paper in BMJ Open: