09 Dec

Dismantling the invisibility trap for children with drug-resistant tuberculosis

Tuberculosis (TB) is an airborne infectious disease that is both preventable and curable, yet it kills more than a million people every year. Children are highly vulnerable, but often invisible casualties. Drug-resistant forms of TB are on the rise globally, and children are as vulnerable as adult but less likely to be counted as cases of drug-resistant disease if they become sick. Four factors make children with drug-resistant TB ‘invisible’: first, the nature of the disease in children; second, deficiencies in existing diagnostic tools; third, overreliance on these tools; and fourth, our collective failure to deploy one effective tool for finding and treating children – contact investigation. Provisional annual targets, focused on children exposed at home to multidrug-resistant TB, to be updated every year, constitute a framework to focus attention and collective actions at the community, national and global levels. The targets tell us the number of: (i) children who require complete evaluation for TB disease and infection; (ii) children who require treatment for TB disease; and (iii) children who would benefit from preventive therapy.

Download full text here –  A targets framework: Dismantling the invisibility trap for children with drug-resistant tuberculosis

Full Citation:
Becerra MC, Swaminathan S. Dismantling the invisibility trap for children with drug-resistant tuberculosis. Journal of Public Health Policy (2014) 35, 425-454, published online 11 September 2014. doi:10.1057/jphp.2014.35

22 Oct

What’s in a number? Two recent reports on pediatric TB cases

This webinar recorded on October 09, 2014 reviews the following:

  • A 2014 report estimating global childhood TB disease incidence, including multidrug-resistant TB
  • A 2014 report estimating childhood TB infection and disease in high TB-burden countries
  • Practical implications for clinicians and other child health advocates

View a recording of the webinar here.

View a PDF version of the slides here.

10 Jul

Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modeling study

Members of the Sentinel Project Network have published a paper titled, “Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study.” The paper was published in early online publication in the The Lancet Global Health on July 9, 2014. The aim of this paper is to estimate the incidence of infection and disease in children, the prevalence of infection, and household exposure in the 22 countries with a high burden of disease.

You can access an article highlighting the paper here.

Full Reference: Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study Dr Peter J Dodd PhD,Elizabeth Gardiner MSc,Renia Coghlan MPH,James A Seddon PhD The Lancet Global Health – 9 July 2014  DOI: 10.1016/S2214-109X(14)70245-1

21 Jun

MDR-TB weight-based dosing chart for children

This dosing chart provides recommendations for the acceptable doses of second-line TB drugs for children. This chart, available here, was developed by a team of experts in November 2013 based on published data as well as new PK data on the fluoroquinolones and aminoglycosides. The doses are based on weight bands and use tablet sizes currently available in most TB programs. Because children being treat for DR-TB often gain weight quickly, it is recommended that dose adjustments be considered on a regular basis (i.e. monthly).

For important disclaimers on the use of this dosing chart, please refer to the disclaimer section available in the Sentinel Project’s “Management of Drug-Resistant Tuberculosis in Children: A Field Guide

06 Jun

Adverse effects and adherence in children treated for MDR-TB

This webinar recorded on June 6, 2014 covers the following topics:

  • Adverse effects of the TB medications commonly used to treat MDR-TB;
  • Management of the most frequent and clinically relevant adverse effects in children with MDR-TB; and
  • Adherence challenges and strategies to support optimal treatment adherence.

View a recording of the webinar here. View a PDF version of the slides here.

21 May

Household considerations in the management of children with DR-TB: Contact tracing and infection control

Because DR-TB is a disease of families, this webinar recorded on May 21, 2014 focuses on the impact of DR-TB on the household, specifically:

  • Active case-finding strategies for DR-TB, including household contact surveys;
  • Results of published DR-TB household contact studies;
  • Approaches to DR-TB prevention in households and the community, including preventive therapy and infection control.

View a recording of the webinar here. View a PDF version of the slides here.

25 Apr

Regimen design and dosing for children with drug-resistant TB: A case-based discussion

This webinar recorded on April 25, 2014 was presented by Drs. Jennifer Furin and James Seddon, members of the Sentinel Project on Pediatric Drug-Resistant Tuberculosis. This case-based discussion covers key principles for regimen construction in children with DR-TB, the latest dosing recommendation and PK data on second-line drugs in children, and the use of new TB drugs and regimens in children with DR-TB.

View a recording of the webinar here. View a PDF version of the slides here.