Although treatable, tuberculosis (TB) is still one of the leading infectious diseases in the world with an estimated 10.6 million people newly affected in 2022. Sierra Leone was listed on the WHO list of 30 high-burden countries with TB in 2016 and in 2019, TB was ranked as one of the top 10 leading causes of death in the country. While 8o per cent of people above 15 years with TB were estimated to be receiving treatment in the country, only 61 per cent of children and adolescent below the age of 15 years were receiving treatment. MSF has been supporting the Ministry of Health in Sierra Leone through the National Leprosy and Tuberculosis Control Program (NLTCP) to provide TB care and management in Makeni city and its surrounding rural communities in Bombali district, northern province of Sierra Leone. The project focuses on a decentralized and ambulatory model of care for the treating drug-resistant - TB (DR-TB), using all oral medication regimens as well as improving quality of diagnosis and treatment of drug-sensitive TB (DS-TB) in Bombali district, with a specific focus on children. The project has implemented the use of the WHO treatment decision algorithm for paediatrics TB, an effective sample transportation system, new TB testing methods (TB LAM and GeneXpert testing) as well as incorporating nutritional support to patients who are undernourished while taking their TB treatment. This has help improve treatment succession rate by 84 per cent for DR TB and 65 per cent for DS TB.