On April 7, 2017 the Sentinel Project co-sponsored a webinar with DR-TB STAT, entitled “The Time Has Come: The Case for Injectable-Sparing Treatment Regimens for Children with MDR-TB.” Dr. Ethel Weld reviewed evidence and experience that supports the treatment of children with MDR-TB disease using regimens that do not require an injectable agent. Dr. Weld was joined by Dr. Kelly Dooley as commentator and Dr. Jennifer Furin as moderator. Slides from the webinar with Dr. Weld are available here, and the corresponding article published on March 23, 2017 in the Lancet Respiratory Medicine is available here.
On March 13, 2017, the World Health Organization issued a meeting report that included evidence on the use of bedaquiline in 537 individuals treated for MDR-TB disease, including adolescents. In light of this new data, a group of clinical experts from the Sentinel Project developed a brief update on bedaquiline, with recommendations to clinical providers and national TB programs. Please see the summary and recommendations here.
The Sentinel Project resource “Management of Multidrug-Resistant Tuberculosis in Children: A Field Guide, Third Edition” is now available.
This field guide is meant to serve as a tool for practitioners working with children at risk of infection or becoming sick with MDR-TB. This guide was developed by a team of experts who jointly have treated hundreds of children with MDR-TB over the last two decades in every region of the world. We hope it will be used in the field to rapidly increase the number of children receiving effective care for MDR-TB.
The guide focuses on issues relevant in clinical and programmatic practices and does not offer extensive background materials on management of MDR-TB, which can be found here. Case examples are included throughout the guide to demonstrate how the recommendations put forth in the field guide can be translated into practice. The third edition features updated information and incorporates two new anti-tubercular agents, bedaquiline and delamanid.
The third edition of the Field Guide is available in English here.
Spanish and Russian translations of the third edition are not yet available. Please send a note to Sentinel_Project@hms.harvard.edu if you need the Spanish or Russian translation.
Did you miss the webinar “An Update on the Use of Bedaquiline and Delamanid in Children with MDR-TB,” which provided an update and synthesized timely clinical guidance on the use of bedaquiline and delamanid in children with MDR-TB? Slides from the webinar with Dr. Jennifer Furin are available here, and the resource referred to in the webinar “Rapid Clinical Advice: The use of Bedaquiline and Delamanid in Children with MDR-TB” is available as a PDF here.
The Sentinel Project’s Advocacy Task Force has developed “Rapid Clinical Advice” on the use of new TB drugs in children. This was produced by a global committee of 18 clinicians who are experts in the management of MDR-TB in children.
This document is meant to complement the Sentinel Project’s Field Guide on the management of MDR-TB in children (available here) and synthesize timely clinical guidance on the use of new drugs for providers who are caring for children with drug-resistant TB. Rapid Clinical Advice: The Use of Bedaquiline and Delamanid for Children with Drug-Resistant Tuberculosis is available as a PDF here.
In collaboration with the Global TB Program at Texas Children’s Hospital, Sentinel Project members wrote, illustrated, and designed an activity book for children affected by TB. The activity book, “We can defeat TB! A book of stories and activities to learn about tuberculosis,” is currently available for download in English and SiSwati. This resource is not available in print at this time.
In the December 2015 edition of Public Health Action, a Sentinel Project task force published the results of their work. In this original report, they aimed to systematically identify and rank research priorities in childhood drug-resistant TB through a survey of the Sentinel Project network. Research priorities identified in the study include the best combination of existing diagnostic tools for early diagnosis, reasons for and interventions to improve treatment outcomes, adverse effects of drugs and optimal treatment duration, prevalence of drug-resistant TB, and interventions for optimal diagnosis, treatment and modalities for treatment delivery.
We thank all of the colleagues who participated in the survey.
On April 12-13, 2015, members of the Sentinel Project participated in the “Global Consultation on Best Practices in the Delivery of Preventive Therapy for Households Exposed to Drug-Resistant Tuberculosis” held in Dubai, UAE at the Harvard Medical School Center for Global Health Delivery–Dubai. A global panel of 51 tuberculosis practitioners from 33 cities in 19 countries gathered to synthesize evidence and produce practical guidance for the management of children and adults who are household contacts of patients with DR-TB. Download the full meeting proceedings “Global Consultation on Best Practices in the Delivery of Preventive Therapy for Households Exposed to Drug-Resistant Tuberculosis” as a PDF here.
A policy brief outlining principles and recommendations for the management of children and adults who are household contacts of patients with DR-TB was also produced from the meeting. Download the policy brief “Post-Exposure Management of Multidrug-Resistant Tuberculosis Contacts: Evidence-Based Recommendations” as a PDF here.
From December 2nd through 6th, 2015, TB researchers, practitioners, caregivers and advocates from around the world will be convening in Cape Town, South Africa for the 46th annual Union World Conference on Lung Health. Throughout the conference, experts in pediatric drug-resistant TB – including several Sentinel Project members and partners – will be hosting symposia, poster discussion sessions, oral abstract sessions, post-graduate courses and “Meet the Expert” sessions to discuss new developments in pediatric DR-TB.
We are excited to announce a symposium on Friday, December 4th entitled, “Research is needed to increase children’s access to drug-resistant TB care,” where several Sentinel Project members and colleagues will advocate for improvements in pediatric DR-TB research. For more information on this event, read our blog post here.
In addition to this symposium, Sentinel Project network members are conducting a post graduate course entitled “Best practices in the management of the second-line injectable drugs in children with multidrug-resistant TB,” scheduled from 09:00-16:00 on in Room MR 1.41 on Wednesday, December 2, 2015 during the conference. Click here to access the agenda for this event and see here for more information on pediatric DR-TB events.
We look forward to many productive discussions in Cape Town this December and hope to see many of you there!