Medical charity urges governments to do more to prevent childhood TB

Governments must implement the latest World Health Organization guidelines to prevent children dying from tuberculosis, according to Médecins Sans Frontières.

It has welcomed a WHO report Roadmap towards ending TB in children and adolescents, which follows the TB guidelines for children and adolescents published last year.

Dr Gabriella Ferlazzo, TB medical adviser for MSF’s Access Campaign, said: “The WHO’s recommendations serve as a crucial tool to help health workers diagnose TB in children in all settings, even when there is limited access to laboratory tests and x-ray, but we’re still not seeing enough countries implementing them to save more children’s lives.

“We urge governments to adopt and start putting the WHO recommendations into practice so that more children are diagnosed and started on treatment right away, which also means training and support for staff to make this possible. Governments must leave no stone unturned to find every child with TB and treat them right away.”

It warns under-diagnosis of TB in children has led to under-treatment and high numbers of deaths because diagnostic tests available for adults with TB are not adapted for use in children. Sputum is the preferred specimen used to test TB in adults, but most children are unable to cough up sputum on demand.

WHO now recommends that children are tested on gastric, nasopharyngeal or stool samples using the GeneXpert Ultra test. However, getting gastric fluid samples from children can be invasive and often difficult to achieve, which leaves stool testing as the only option in many settings, even if this option still poses practical difficulties.

MSF says there is an urgent need for more research and development to find better tests to diagnose TB in children.

Dr Nasiba Maksumova, who works in MSF’s TB project in Tajikistan, said: “It’s baffling that this deadly but curable disease has existed for millennia, but in the 21st century, still only 40% of children with TB get the treatment they need to stay alive, because the right tools to test TB in kids still don’t exist.

“We desperately need more effective TB tests for children that can be used in the most remote settings using samples that are easy to collect, like mouth swabs or finger-prick blood. More efforts are needed from researchers, donors and pharmaceutical corporations to develop improved TB tests, and once developed, these must be available and affordable in all countries with high TB burdens. Children with TB can’t afford to wait any longer for the world to get its act together on this deadly disease.”

It is also a challenge to implement preventive treatment in children and adolescents who have been in close contact with people affected with TB in their family or in the community.

Three-month regimens to prevent TB have been recommended for many years for children, but their scale up remains insufficient, which means countries must increase access to preventive treatments and start eligible children on these treatments to reduce the risk of this vulnerable population developing active TB, MSF says.

“After decades of pressure and waiting, we finally have child-friendly formulations of drugs to prevent TB,” said Dr Kennedy Uadiale, who works in MSF’s project in Sierra Leone.

“Still so few kids get preventive TB drugs because the screening process to identify them is so cumbersome. It’s time now for countries to fulfil commitments made in the UN Political Declaration on TB last month and save lives by reaching all children affected by TB.”

, , ,

Leave a Reply

Your email address will not be published. Required fields are marked *



Monthly Posts

Our Clients

Practice Index