On July 15 2013, the Sentinel Project, sponsored by the United States Agency for International Development’s TB CARE II project, organized “Improving the Quality of Care for Children with Drug-Resistant TB” in Dhaka, Bangladesh. The workshop was attended by a total of 35 participants, primarily pediatricians from public and private hospitals and medical colleges. Local and international experts presented on pediatric MDR TB, diagnostic and treatment challenges, strategies for ensuring treatment adherence, monitoring and infection control. A special session demonstrated the gastric aspirate, a technique used for obtaining sputum samples from very young patients. Participants discussed and recommended priority actions for scaling up the availability of services for pediatric MDR TB patients in Bangladesh. The recommendations include establishing a working group to oversee the planning and implementation of pediatric MDR-TB activities and provide clinical guidance; the design and implementation of a pilot project on contact tracing including specimen collection and referral; conducting operational research to support policy and strategy formulations; and updating medical curricula to improve education on the management of childhood TB.
We are pleased to share a recent poster presentation: “Administering Second-Line Antituberculous Medications to Children with Multidrug-Resistant Tuberculosis: A Qualitative Study.” The poster was presented by Erica Lessem at the Clinical Pharmacology Workshop on New TB Drugs on September 9, 2013 in Denver Colorado. This poster presents results from a very small qualitative study of clinicians providing care to children with MDR-TB, and points to the need to improved pediatric formulations for second-line drugs.
From June 17-19 2013, the National Institute for Research in Tuberculosis and the Sentinel Project on Pediatric Drug-Resistant TB sponsored a training workshop on “Improving the Quality of Care for Children with TB and Drug-Resistant TB” in Chennai, India. The workshop was attended by 48 participants, primarily pediatricians from the public, private, and university sector, including all states of India and Nepal. The course was well-received by participants and all participants were engaged actively in the program. There was lively discussion and debate on both clinical and policy issues. The summary report can be found here, and recommendations can be found here.
On March 21, 2013, the Sentinel Project on Pediatric Drug-Resistant Tuberculosis and Treatment Action Group (TAG) published We Can Heal, a collection of stories of 30 children in 30 countries affected by this disease. The stories call for urgent attention to this global threat to children, and are a testament to the need for improved programs, policies, and tools. The global community must commit long overdue political will and resources to address the gaps identified in this collection and to tackle all forms of TB in children necessary to achieve zero TB deaths, new infections, and suffering.
The stories submission page for Phase II of the Sentinel Project on Pediatric Drug-Resistant Tuberculosis is now live! Check it out here.
As the January 24th deadline approaches, we are still working to collect stories from as many countries as possible to highlight in our next report, which will be launched on World TB Day, March 2013. Please help us identify stories of children with DR-TB to highlight in our report. It can be a child who died with or without treatment, or a good outcome — we are gathering both.
Alternatively, if you do not personally know of any cases, but know of a colleague who might, please pass this request along and refer them to the new “submissions page” of the Sentinel Project website. There are links available on the submissions page where they can download the story collection framework document in English (attached), French, Spanish and Russian — this framework includes a consent form and details the type of information we are looking to include in the stories we collect.
We look forward to working together to advocate for better drugs and drug formulations, diagnostics, and access to care for children with DR-TB!
Dr. Tengiz Gvasalia, head of pediatric TB programs in the country of Georgia, died on February 13, 2012 at the age of 65. Dr. Gvasalia was a compassionate pediatric TB provider who saved the lives of hundreds of children with TB in Georgia. In addition, he was the first physician to treat children with drug-resistant TB in the country. He was an exemplary doctor, skilled leader, and a masterful teacher. Perhaps most importantly, Dr. Gvasalia was a fierce advocate for children with TB.
Dr. Gvasalia was much beloved by those he cared for and it was common to see him surrounded by his young patients and their families outside of the children’s TB hospital in Tbilisi. His warmth was felt by all who encountered him. In addition to providing high quality medical care, Dr. Gvasalia recognized the horrible social conditions faced by many of his patients and their families. He went out of his way to make sure their needs were met–including providing food, housing, clothes, and toys for the families under his care. An avid artist, he taught the children and families in his care to use art as part of their healing. “Without him here,” noted a colleague, “the place is not the same. We have lost our heart.”
Dr. Gvasalia was memorialized at a service on Friday, February 17th held at the National Center for TB and Lung Disease in Tbilisi. A memorial fund has been established in his name to continue to meet the social needs of his patients and their families. In this way, Dr. Gvasalia will continue to provide comfort and health to the smallest victims of TB. For inquiries or to make a donation, please contact Dr. Jennifer Furin (firstname.lastname@example.org).