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.

15 May

We can defeat TB! A book of stories and activities to learn about tuberculosis

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.

27 Jan

Proceedings: Global Consultation on Best Practices in the Delivery of Preventive Therapy for Households Exposed to Drug-Resistant Tuberculosis

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.

09 Nov

Post-Exposure Management of Multidrug-Resistant Tuberculosis Contacts: Evidence-Based Recommendations

The Harvard Medical School Center for Global Health Delivery–Dubai celebrated its inaugural symposium on Sunday, October 25, 2015 at the Mohammed Bin Rashid Academic Medical Center in Dubai Healthcare City. At the launch, the Center distributed a policy brief, “Post-Exposure Management of Multidrug-Resistant Tuberculosis Contacts: Evidence-Based Recommendations,” which was written by Sentinel Project members.

The principles and recommendations outlined in this policy brief were developed by a global panel of 51 tuberculosis practitioners from 33 cities in 19 countries who gathered at the Harvard Medical School Center for Global Health Delivery–Dubai on April 12 and 13, 2015. This global consultation provided a forum for TB practitioners to synthesize evidence and produce practical guidance for the management of children and adults who are household contacts of patients with DR-TB. Following the meetings and a review of published and unpublished evidence, the panel arrived at a set of seven principles summarized in this policy brief, along with the process employed to produce them.

Download “Post-Exposure Management of Multidrug-Resistant Tuberculosis Contacts: Evidence-Based Recommendations” as a PDF here.

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.

09 Nov

SAVE THE DATE – Pediatric DR-TB Symposia, Poster Sessions and More at the 46th Union World Conference on Lung Health

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!

For more information about the 46th annual Union World Conference on Lung Health, please visit their websitehttp://capetown.worldlunghealth.org/.

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

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

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

Description

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.

Presentations

  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

Description

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.

Presentations

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)