11 Jul

Recommendations for Injectable-Free Regimens in Children with Rifampin-Resistant Tuberculosis

In June 2018, the South African National Department of Health announced that bedaquiline will now be used to replace the injectable agent in routine treatment of rifampin-resistant and multidrug resistant tuberculosis (RR/MDR-TB) in patients over 12 years of age. We congratulate the leadership of the South African National TB program for taking this important step.

We note with some concern that children under the age of 12 years may be precluded from accessing the benefits of an all-oral RR/MDR-TB regimen. As such, we call for policies to support all-oral regimens for patients under 12 years of age in South Africa and globally.  In partnership with the Desmond Tutu Tuberculosis Centre (DTTC) and Treatment Action Group (TAG), Sentinel Project has developed the following recommendations for injectable-free regimens for children under the age of 12 years.
Please download these recommendations here: Recommendations for Injectible-Free Regimens in Children with Rifampacin Resistant TB.

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.

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.

11 Apr

Consensus statement on research definitions for drug-resistant tuberculosis in children

We are delighted to announce and share a new resource emerging from our network’s collaboration, “Consensus Statement on Research Definitions for Drug-Resistant Tuberculosis in Children.” The paper was published online in the Journal of Pediatric Infectious Diseases Society yesterday and the full reference is below. It was written by a Sentinel Project Task Force led by James Seddon. The aim of this paper is to advance a consistent terminology for use in research that we hope will result in more comparable data about children with DR-TB which can lead to more efficient syntheses and collective learning.

We also want to thank Professors Anneke Hesseling and Simon Schaaf of Stellenbosch University who provided funds to cover the costs of making this article immediately ‘Open Access.’

Full reference: Seddon JA, Perez-Velez CM, Schaaf HS, Furin JJ, Marais BJ, Tebruegge M, Detjen A, Hesseling AC, Shah S, Adams LV, Starke JR, Swaminathan S, Becerra MC, on behalf of the Sentinel Project on Pediatric Drug-Resistant Tuberculosis. Consensus statement on research definitions for drug-resistant tuberculosis in children. Journal of the Pediatric Infectious Diseases Society, first published online April 10, 2013. doi:10.1093/jpids/pit012