The World Health Organization (WHO) currently recommends shortened treatment for mild children tuberculosis (TB), and two oral tuberculosis treatments (bedaquiline and delamanid) for use in children of all ages. The latest guidelines for TB management in children and adolescents were published on March 21, prior to World Tuberculosis Day on March 24.
Authorities also noted that tuberculosis deaths increased for the first time in more than a decade in 2020 and called for increased investment in global tuberculosis programs. “We cannot undermine our commitment to reach out and save all men, women, children, families and communities affected by this deadly disease,” said the director of the WHO Global Tuberculosis Program. Dr. Terezaka Saeva, MD, said. Press conference..
TB is 13th most common cause of death And it is the second most infectious murderer after COVID-19, with more than 4,100 people dying from tuberculosis every day. WHO estimates that 1.1 million children suffer from tuberculosis each year.
Call for investment
The increase in TB deaths from 1.4 million in 2019 to 1.5 million in 2020 was coupled with a decline in funding. From 2019 to 2020, global spending on tuberculosis diagnosis, treatment and prevention services fell from $ 5.8 billion to $ 5.3 billion. That’s less than half of the $ 13 billion target for 2022, Casaeva said.
Efforts to increase access to tuberculosis treatment have been inadequate, primarily due to this lack of funding, especially for children. By 2020, it was reported that approximately 63% of children under the age of 15 with tuberculosis had no or no access to tuberculosis diagnosis and treatment services. This rose to 72% of children under the age of five.According to the report, even five years old had not received tuberculosis prophylaxis in 2022. WHO statistics..
The socio-economic implications of the COVID-19 pandemic, as well as the ongoing conflicts in Eastern Europe, Africa and the Middle East, “further exacerbated the situation,” said Casaeva. “This conveys the urgent need to dramatically increase investment in order to strengthen the fight against tuberculosis and achieve the commitment of world leaders to eradicate tuberculosis.”
Casaeva states the WHO’s key points regarding global investment in tuberculosis treatment:
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Increase national and international funding to bridge the gap in tuberculosis research and program implementation. Smaller economies need to increase international investment in the short or medium term to regain progress.
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Double funding for tuberculosis research, including vaccines.
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Invest in TB program and service maintenance during the COVID-19 pandemic and ongoing crisis to ensure uninterrupted care.
New guidelines
Kasaeva also stated that the adoption of new WHO guidelines for children and adolescents should be urgently pursued to improve access and quality of care. Updates include:
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A rapid molecular test called Xpert Ultra should be used as an initial test for tuberculosis in children and adolescents.
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Diagnostic tests can now include non-invasive specimens such as fecal samples.
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Children with mild tuberculosis 4 months shorter regimen, Not 6 months. KerriViney, MD and PhD, team leaders of the WHO Tuberculosis Program, have focused on vulnerable people, including children, and this shortened regimen allows children to return to school faster and save on family and health care system costs. It says it can be done. She announced her new guidelines at a WHO press conference.
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Recommended treatment regimen for tuberculosis Meningitis It has also been reduced from 12 months to 6 months.
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Currently, two oral medications for drug-resistant tuberculosis (bedaquiline and delamanid) are recommended for use in children of all ages. “We no longer need painful injections that can cause serious side effects such as deafness,” Viney said.
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Health systems need to develop new models of decentralized and integrated TB treatment to bring TB treatment closer to where children live.
Guidelines are available here..
“The WHO guidelines published today are game changers for children and adolescents with tuberculosis,” said Casaeva. The next step is to help countries implement these updates and give children and adolescents around the world access to quality TB treatment, “Viney added. There is implementation guidance and prescriptions for child-friendly tuberculosis drugs, “she said. Invest to end tuberculosis in children and adolescents. “
