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Our results highlight a large-scale lack of awareness about children with MDR- and XDR-TB. The absence of publications documenting child MDR- and XDR-TB cases in settings where MDR- and XDR-TB in adults have been reported indicates both exclusion of childhood disease from the public discourse on drug-resistant TB and likely underdetection of sick children. Our results highlight a large-scale lack of awareness about children with MDR- and XDR-TB. Seventeen rural public health facilities in Western Kenya that introduced three mode