31 Oct

Post-graduate course 04: Managing children with drug-resistant tuberculosis: a practical approach

Post-graduate Course 04. Managing children with drug-resistant tuberculosis: a practical approach

Thursday, 31 October 2013, 9:00 – 17:00, Room: 341

44th Union World Conference on Lung Health, 30 October – 3 November 2013, Paris, France


Despite some advances in expanding access to effective treatment for drug-resistant tuberculosis (DR-TB), children remain largely neglected. Diagnosis of DR-TB in children is perceived to be challenging and few providers have experience managing children with DR-TB. This course aimed to provide workers with practical advice and guidance to manage children with DR-TB. It addressed diagnosis, prevention, treatment, delivery of medication doses, management of adverse events, and approaches to the programmatic management of DR-TB in children.

This course was aimed at any health care worker who may manage children with drug-resistant tuberculosis. The course’s strong clinical and practical components were of use to those working in the community, clinic, hospital, or TB programme.


  1. Overview of the epidemiology of DR-TB in children
    Soumya Swaminathan (India)
  2. Family-centered approach: framework for managing children exposed to DR-TB
    Jeffrey Starke (USA)
  3. Diagnosis of DR-TB disease in children
    Carlos Perez-Velez (USA)
  4. Treatment of DR-TB disease in children and preventive therapy for children exposed to DR-TB
    H. Simon Schaaf (South Africa)
  5. Pharmacokinetics of second-line TB drugs
    Helen McIlleron (South Africa)
  6. Practical approach to weight-based dosing
    Carole Zen Ruffinen (Switzerland)
  7. Co-morbidities, monitoring and adverse events, nutritional support and adherence
    Jennifer Furin (USA)
  8. Program monitoring and evaluation, including registers and forms
    Florian Marx (Germany)
  9. Implementing a protocol to evaluate child contacts of DR-TB patients
    Farhana Amanullah (Pakistan)
  10. Managing DR-TB in pregnancy, mothers and newborns
    James Seddon (UK)

Coordinators: Mercedes Becerra (USA), James Seddon (UK)

Chairs: Mercedes Becerra (USA), James Seddon (UK)



31 Oct

The inclusion of children in national TB prevalence surveys: a critical step towards achieving zero TB deaths

Thursday, 31 October 2013, 13:30 – 17:00, Room: 251

44th Union World Conference on Lung Health, 30 October – 3 November 2013, Paris, France

Workshop sponsored by The Stop TB Partnership


Prevalence surveys are important for measuring the burden of, and trends in, TB disease. With these data, national tuberculosis programmes (NTPs) can assess the impact of their efforts,and identify the reasons why cases may not have been diagnosed. This information can then be used to identify strategies for improving the rate of case detection, attaining more timely diagnosis, and providing better treatment. However, the majority of countries continue to not include children less than 15 years of age in their national surveys of TB disease, even though they constitute approximately a third of their population.

This symposium was targeted at health policy-makers, public health officials, epidemiologists, technical advisors, patient advocates, implementers, clinicians (physicians, nurses, physiotherapists, respiratory therapists), and researchers. Its objectives were to:

1. Review the history of TB prevalence surveys that included children and the measures taken to accomplish this.
2. Review the epidemiologic science, the tools, and the related ethical considerations, for including children.
3. Review the implementation science for measuring TB burden in children, in resource-limited and -rich countries.
4. Review the reasons why the inclusion of children in national TB prevalence surveys has not been recommended.
5. Promote discussion on the inclusion of children in national prevalence surveys of TB disease.


1. Importance and history of measuring the burden of TB disease in children
Peter Donald (South Africa)

2. The epidemiological science for measuring the burden of TB disease in children
Annelies Van Rie (USA)

3. The implementation science for measuring the burden of TB disease in children
Anneke Hesseling (South Africa)

4. Current recommendations and supportive efforts of the WHO for measuring the burden of TB disease in children
Babis Sismanidis (Switzerland)

5. Potential solutions for overcoming the challenges in measuring the burden of TB disease in children
Jeffrey Starke (USA)

6. Round-table discussion: how should countries measure their burden of TB disease in children?
Elizabeth Gardiner (USA)

Coordinators: Carlos Perez-Velez (USA), Soumya Swaminathan (India)

Chairs: Steve Graham (Australia), Carlos Perez-Velez (USA)

(Photo credit: Stop TB Partnership, Shehzad Noorani)