“Children affected by tuberculosis are being left behind in the global effort to end” this infectious respiratory disease, warns Doctors Without Borders (MSF), an organization that warns that many countries have not implemented the recommendations of the World Health Organization ( WHO). their national policies.
<img width="1000" height="665" class="attachment-newpress-featured-large size-newpress-featured-large wp-post-image lazyload" alt="MSF advierte: Los niños con tuberculosis se están quedando atrás de las políticas mundiales" decoding="async" fetchpriority="high" data-attachment-id="359732" data-permalink="https://efesalud.com/tuberculosis-ninos-politicas-oms-msf-informe/fatmata-and-isatus-story/" data-orig-file=" data-orig-size="1000,665" data-comments-opened="0" data-image-meta="{"aperture":"0","credit":"Mohamed Saidu Bah/MSF","camera":"","caption":"40-year-old Fatmata Turay giving her granddaughter, Isatu Kamara, ready-to-use therapeutic foods (RUTF). They sit outside the tuberculosis Direct Observation Therapy (DOT) site adjacent to the Ministry of Health primary health care facility in Kamaranka, Bombali District, Sierra Leone. MSF teams support that facility with testing and treatment of paediatric patients with drug sensitive tuberculosis (DS-TB). nnIsatu is 11 months old and is from Bombali District. Her grandmother has been treated for tuberculosis since November 2022, and it is likely that Isatu contracted tuberculosis from her, since she is her primary caregiver. Isatu started her TB treatment in June 2023, and was immediately treated for severe acute malnutrition (SAM). nnTuberculosis preventive treatment (TPT) is not available yet throughout Sierra Leone, leaving family members of patients affected by tuberculosis at higher risk of contracting the disease, especially the most vulnerable ones such as children and immunocompromised patients due to HIV or malnutrition.","created_timestamp":"0","copyright":"","focal_length":"0","iso":"0","shutter_speed":"0","title":"Fatmata and Isatu's Story","orientation":"0"}" data-image-title="Fatmata and Isatu’s Story" data-image-description="" data-image-caption="
A woman feeds her granddaughter suffering from tuberculosis at a medical center in Sierra Leone. MSF/Mohamed Saidu Bah
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A woman feeds her granddaughter suffering from tuberculosis at a medical center in Sierra Leone. MSF/Mohamed Saidu Bah
This is reflected in the report.”Testing, preventing and treating tuberculosis in children”MSF’s TACTIC, which, through surveys, evaluates tuberculosis policy guidelines in 14 countries with a high disease burden and reveals that many are behind in updating those policies that could help stop the disease.
THE World Health Organization (WHO) An estimated 1.25 million children and adolescents (0 to 14 years old) become ill with tuberculosis every year, but only half of them are diagnosed and reported to national tuberculosis programmes.
Tuberculosis is caused by a bacterium (Mycobacterium tuberculosis) and most commonly affects the lungs. It is spread through the air when infected people cough, sneeze or spit.
MSF requests
MSF calls on the most affected countries and those analyzed in its report to update their anti-tuberculosis guidelines: Afghanistan, Central African Republic, Democratic Republic of Congo, Guinea, India, Mozambique, Niger, Nigeria, Pakistan, Philippines, Sierra Leone, Somalia, South Sudan and Uganda.
Calls for the necessary resources to be allocated – together with the development of clear plans with deadlines – to implement policies and increase access to prevention, diagnosis and treatment of children with tuberculosis in the country.
This medical NGO is also calling on international donors and technical support agencies to provide sufficient funding to countries to support pediatric tuberculosis policy reforms and implementation.
The gaps
Of the 14 policy indicators measured in the MSF report, only one country’s policies are fully aligned with WHO guidelines, seven countries have more than 80% alignment, and four countries are still below 50%.
The greatest gaps were found in policies related to the diagnosis of tuberculosis in children.
According to the report, only 5 out of 14 countries have adapted their guidelines to begin treatment of this disease in children when symptoms clearly indicate the presence of tuberculosis even if bacteriological tests are negative.
And only 4 of these 5 countries have the resources needed to effectively implement these guidelines.
<img decoding="async" width="750" height="1000" data-attachment-id="359734" data-permalink="https://efesalud.com/tuberculosis-ninos-politicas-oms-msf-informe/drug-resistant-tuberculosis-dr-tb-treatment-in-kandahar/" data-orig-file=" data-orig-size="750,1000" data-comments-opened="0" data-image-meta="{"aperture":"0","credit":"Paul Odongo/MSF","camera":"","caption":"Nazdana* and her daughter seated in the waiting area inside the TB clinic in Kandahar. For more than three years Nazdanau2019s* tuberculosis journey has been filled with ups and downs. The 30-year-old mother of four travelled from Uruzgan, a province that neighbours Kandahar, to seek treatment at the MSF clinic. She had a persistent cough and dizziness, and then a sudden onset of vomiting after meals which left her with no appetite. She completed her treatment in Kandahar after nine months and was discharged after a further five months of follow up. Her seven-year-old daughter, who was diagnosed with TB following contact tracing by MSF is still an inpatient.","created_timestamp":"0","copyright":"","focal_length":"0","iso":"0","shutter_speed":"0","title":"Drug-Resistant Tuberculosis (DR-TB) Treatment in Kandahar","orientation":"0"}" data-image-title="tuberculosis, msf" data-image-description="" data-image-caption="
A woman and her daughter wait at an MSF tuberculosis center in Kandahar, Afghanistan. MSF/Paolo Odongo
” data-medium-file=” data-large-file=” alt=”tuberculosis children” class=”wp-image-359734 lazyload” style=”width:412px;height:auto” src=” srcset=” 750w, 225w, 600w, 450w, 300w, 150w” data-sizes=”auto” data-eio-rwidth=”750″ data-eio-rheight=”1000″/>A woman and her daughter wait in an MSF treatment center tuberculosis in Kandahar (Afghanistan). MSF/Paolo Odongo
Diagnosis, a challenge
Diagnosing pediatric tuberculosis is more difficult than diagnosing adult tuberculosis because children often fail to produce sputum, have lower levels of bacteria in their lungs than adults, which current tests often miss, and are more likely to suffer of extrapulmonary tuberculosis compared to adults.
“Diagnosing tuberculosis in children is a challenge because currently available laboratory tests are not suited to children’s needs,” reads the report, which admits that some countries allow treatment to begin without bacteriological testing.
However, fewer countries have adopted the evidence-based treatment decision algorithms recommended by WHO, which are key to increasing the number of children diagnosed with tuberculosis in the absence
Prevention, especially for the most vulnerable
Preventive tuberculosis treatment is a “particularly valuable tool” for protecting the most vulnerable children, including children living with HIV and children under 5 years of age who are in close contact with an adult with tuberculosis.
“It is encouraging to see that all countries surveyed include at least a shorter preventive tuberculosis treatment regimen for children under 5 years of age,” although, she points out, children living with HIV are still excluded.
WHO recommendations
Based on the latest scientific evidence, WHO has revised its guidelines for the treatment of children and adolescents with tuberculosis in 2022 and made several recommendations that would “drastically” improve the diagnosis and quality of care for children.
Among these stand out:
- The use of therapeutic decision-making algorithms which allow many children to be diagnosed based solely on symptoms in the absence of laboratory confirmation.
- Offer shorter treatments to treat and prevent tuberculosis in children, especially drug-sensitive and drug-resistant tuberculosis.
MSF regrets that although new child-friendly drugs exist for drug-susceptible and drug-resistant tuberculosis, countries do not always acquire them due to bureaucratic barriers and lack of funding.
“As a result, children with tuberculosis are forced to ingest crushed, bitter drugs without adequate doses based on their weight, putting them at serious risk of side effects and treatment failure,” it warns. Cathy Hewison, head of Doctors Without Borders’ tuberculosis working group.
Furthermore, according to MSF, the introduction of new anti-tuberculosis drugs and pediatric formulations is essential to enable countries to stop using the drug. amikacinan injectable antibiotic known to cause serious side effects, including permanent hearing loss.
<img decoding="async" width="1000" height="668" data-attachment-id="359737" data-permalink="https://efesalud.com/tuberculosis-ninos-politicas-oms-msf-informe/child-and-mother/" data-orig-file=" data-orig-size="1000,668" data-comments-opened="0" data-image-meta="{"aperture":"0","credit":"Ammar Obeidat/MSF","camera":"","caption":"Child and mother in the waiting area of DRTB ward at Makeni Regional hospital. waiting for TB testing.","created_timestamp":"0","copyright":"","focal_length":"0","iso":"0","shutter_speed":"0","title":"Child and mother","orientation":"0"}" data-image-title="tuberculosis niños África" data-image-description="" data-image-caption="
A mother and her son wait to be tested for tuberculosis in Sierra Leone. MSF/Ammar Obeidat
” data-medium-file=” data-large-file=” alt=”tuberculosis children” class=”wp-image-359737 lazyload” style=”width:700px;height:auto” src=” srcset=” 1000w, 300w, 768w” data-sizes=”auto” data-eio-rwidth=”1000″ data-eio-rheight=”668″/>A woman and her son wait to be tested for tuberculosis at a medical center in Sierra Leone. MSF/Ammar Obeidat
The conclusions
MSF considers it essential that countries update their anti-tuberculosis policies with the joint work of all stakeholders and with funding and technical assistance.
A first step in this process, they propose, is the development of national pediatric tuberculosis roadmaps, which establish concrete plans to update national guidelines and address barriers to implementation to increase access to diagnosis, prevention and treatment. treatment.
#Children #suffering #tuberculosis #abandoned
Ize=”1000,668″ data-comments-opened=”0″ data-image-meta=”{“aperture”:”0″,”credit”:”Paul Odongo/MSF”,”camera”:””,”caption”:”Nazdana and her daughter Seated Together,” created_timestamp”:”0″,”copyright”:””,”focal_length”:”0″,”iso”:”0″,”shutter_speed”:”0″,”title”:”Child and Mother in MSF Clinic”,”orientation”:”0″}” data-image-title=”tuberculosis, msf” data-image-description=”” data-image-caption=”
A woman and her daughter in an MSF clinic for tuberculosis.
” data-medium-file=” data-large-file=” alt=”tuberculosis children treatment” class=”wp-image-359737 lazyload” style=”width:412px;height:auto” src=” srcset=” 750w, 300w, 450w, 600w, 225w, 150w” data-sizes=”auto” data-eio-rwidth=”1000″ data-eio-rheight=”668″/>A woman and her daughter in an MSF clinic for tuberculosis.
Conclusion
Addressing the tuberculosis crisis among children requires urgent action from both national governments and international organizations. Significant gaps in diagnosis, treatment guidelines, and preventive measures highlight the need for reforms and increased support. By implementing WHO recommendations and ensuring access to appropriate medical care, the health of millions of vulnerable children can be improved, ultimately leading to a reduction in tuberculosis incidence and a healthier future for all.