29 Mar

How to Care for People Exposed to Drug-Resistant Tuberculosis: A Practical Guide

The Sentinel Project resource, “How to Care for People Exposed to Drug-Resistant Tuberculosis: A Practical Guide” is now available.

This Guide builds on World Health Organization (WHO) recommendations for the management of individuals who have been exposed to TB and DR-TB, but focuses more on the practical implementation of interventions that should take place in the post-exposure setting. While the WHO policies stress that investigating household contacts of TB patients must be done on an “urgent” basis for all contacts of a patient with DR-TB, there is limited information available on what these evaluations and interventions should include. Furthermore, many of the recommendations and tools that do exist only focus on medical issues, omitting other pressing psychosocial needs that must be routinely assessed as well. DR-TB affects not only individuals but their households as well. Even when only one person has become sick, the whole household requires some intervention to reduce discrimination, improve patient support, and avoid unnecessary morbidity and mortality. This Guide aims to provide a way of thinking about the challenges around those exposed to DR-TB. It also aims to provide guidance on DR-TB prevention and management strategies needed to address the enormous health threat presented by DR-TB, as well as the tools necessary to carry them out.

This Guide is available in English and Spanish.

For additional translations of the Field Guide, please send a note to Sentinel_Project@hms.harvard.edu.

08 Mar

Webinar | MDR-TB Treatment with Bedaquiline in Children and Adolescents: Global Recommendations and Program Experience in Belarus

On November 21, 2017, the Sentinel Project co-sponsored a webinar with DR-TB STAT, entitled “MDR-TB Treatment with Bedaquiline in Children and Adolescents: Global Recommendations and Program Experience in Belarus.” Dr. Alena Skrahina, MD, PhD, DSc, presented interim results of bedaquiline use in the treatment of children and adolescents with multi-drug resistant tuberculosis in Belarus. Dr. Skrahina discussed the acceptability of bedaquiline-containing regimens, culture conversion results, and the occurrence of adverse events. Dr. Skrahina was joined by Dr. Jennifer Furin as commentator and moderator.

11 Apr

Webinar | Injectable-Sparing Regimens for Children

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.

13 Dec

Management of Multidrug-Resistant Tuberculosis in Children: A Field Guide (Third Edition)

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 and Spanish.

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For additional translations of the Field Guide, please send a note to Sentinel_Project@hms.harvard.edu.

16 May

Advancing Access for New TB Drugs for Children

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.