What's New

2020 Virtual annual meeting

The annual meeting of the Child and Adolescent TB Working Group took place on the Webex platform on Friday, 16 October 2020. The meeting was open to all members of the working group representing a broad range of stakeholders including paediatricians, NTP managers and childhood TB focal points in the NTP, MCH representatives, technical and financial partners, community TB representatives and WHO staff from headquarters, regional and country offices. The main purpose was to maintain a vibrant child and adolescent TB community, share country experiences in scaling up the response to child and adolescent TB and to discuss next steps to move the agenda forward. A total of 260 registrations were received, and 192 participants attended the meeting. The meeting was divided into two sessions of 2.5 hours each.

The meeting was opened by Dr. Tereza Kasaeva, the Director of the WHO Global TB Programme, who highlighted recent developments in data on child and adolescent TB, paediatric TB drug optimization and the process of updating the guidelines on the management of TB in children and adolescents. Farhana Amanullah gave the report from the chair on the activities of the working group since the last meeting in October 2019. Annemieke Brands and Sabine Verkuijl from the secretariat provided an update on new WHO policy recommendations relevant to children and progress towards UNGA HLM on TB targets, including an overview of new data included in the Global tuberculosis report 2020.

Karen du Preez from the Desmond Tutu TB Centre at Stellenbosch University presented on an interdisciplinary and multi-level approach to estimate the disease burden and outcomes of childhood tuberculous meningitis (TBM). The main findings of the SHINE trial (Shorter Treatment for Minimal Tuberculosis in Children), a phase III randomised open trial comparing 4 versus 6 months treatment in children (+/- HIV) with smear-negative non-severe TB in Africa and India, were presented by Aarti Avinash Kinikar and Priyanka Raichur. This was followed by an update on paediatric TB prevention trials by Anneke Hesseling. James Seddon then presented a selection of interesting peer-reviewed articles.

In the second part of the meeting, Edine Tiemersma and Endale Mengesha Goshu shared country experiences with the implementation of the Simple One Step stool processing method for Xpert MTB/RIF from Ethiopia and Vietnam. After this, Chishala Chabala presented on emerging experiences with diagnostic approaches in children with HIV, severe pneumonia and malnutrition from the TB-Speed project. Laura Olbrich then presented on T-cell marker-based assays for the diagnosis of tuberculosis in children and adults.

The next session focused on systematic reviews on the risk of TB after exposure and on TB screening in children, with presentations by Leo Martinez and Bryan Vonasek. The last session covered the impact of COVID-19 on child and adolescent TB services, with experiences from Ghana by Anthony Enimil and from the Americas by Celia Martinez. Unfortunately, Rahab Mwaniki could not connect to present on community perspectives on COVID and TB, but her presentation is available on the website.

In the closing session, the Secretariat acknowledged the continuing financial support from USAID through UNOPS.

Meeting Report, Meeting Recording

Presentations

2019 Annual meeting

The annual meeting of the Child and Adolescent TB Working Group took place on Wednesday 30 October 2019 in Hyderabad, India just prior to the 50th Union Conference and was attended by over 110 participants. The annual meeting provides a forum for exchange of global developments and country experiences. The meeting started with a report from the vice chair on the data as included in the Global TB Report 2019 and activities of the working group since the last meeting in October 2018. Anna Scardigli then gave a presentation on the new Global Fund cycle including opportunities for childhood TB. We then had a thematic session on screening, contact investigation and prevention chaired by Connie Erkens of the KNCV Tuberculosis Foundation. It included a presentation by Aimé Loando (EGPAF) on “Improving childhood TB detection through facility-based integrated approaches in Kinshasa, DRC”; a presentation by Leonardo Martinez (Standford University) on “Paediatric TB transmission outside the household” with Ben Marais as discussant; a presentation by Nicole Ritz (University of Basel) on “TB screening in migrant children”; and, a presentation by Jyoti Mathad (Weill Cornell) on “Maternal TB and implications for neonates”. The thematic session ended with a panel discussion on contact investigation and prevention during which Moorine Sekadde childhood TB focal point from Uganda, Tilaye Gudina childhood TB focal point from Ethiopia, Monica Dias (PPM Roadmap), and Nyan Win Phyo, WHO Civil Society Task Force member from Thailand shared their experiences. Simon Schaaf concluded this session with a few words about the TB CHAMP trial on TB preventive treatment for contacts of patients with DRTB. In the afternoon, Prof Kabra (India), Edine Tiemersma (KNCV Tuberculosis Foundation), Olivier Marcy (University of Bordeaux), Pamela Nabeta (FIND), Hannah Kirking (CDC) and James Seddon (Imperial College & Desmond Tutu TB Centre) shared developments in diagnosis of TB in children and adolescents during a panel session moderated by Steve Graham on new diagnostic tools as well as use of alternative specimens. A third session was organized around developments in the treatment of drug-sensitive and drug-resistant TB. Tony Garcia Prats announced, “BENEFIT Kids”, the new Unitaid paediatric MDR-TB project, and placed a call for individual patient data. Di Gibb and Vidya Mave provided an update on the SHINE trial, a phase III randomised trial of treatment shortening in children with minimal TB disease. Alena Skrahina gave a presentation on the use of new drugs for children with DRTB in Belarus. James Seddon provided an overview of 34 recent peer-reviewed articles that should “not be missed”, highlighting different aspects of ending TB in children and adolescents. Finally, Martina Penazzato announced the upcoming TB/HIV meeting hosted by the Vatican in April 2020 (Rome 5). In the closing session, the Secretariat acknowledged the continuing financial support from USAID through UNOPS.

Final Report, Presentations


Roadmap towards ending TB in children and adolescents (French)


First paediatric antituberculosis drug optimization (PADO TB 1) meeting, February 2019

Building on the experience in the WHO HIV programme, the inaugural paediatric antituberculosis drug optimization (PADO TB 1) meeting, which took place on 14 and 15 February 2019 at WHO headquarters in Geneva, aimed to establish a formal transparent process to reach evidence-based consensus among a variety of stakeholders regarding priority antituberculosis drugs and formulations for children. The meeting was attended by 45 participants, with six additional attendees participating remotely, and included representatives from NTPs from TB high burden and priority countries, clinicians, scientists, funding organizations, international organizations and technical partners.

During the first day, presentations covered the size and specifics of the paediatric anti-TB drug market, the concept of paediatric antituberculosis drug optimization, experiences with antituberculosis drug development and market-shaping and the current adult and paediatric TB research and clinical trial landscape, priorities and overview of drug development. Participants engaged in discussions on the PADO for TB mechanism and modus operandi in the context of complementary efforts in paediatric drug optimization as well as the process to reach consensus on short/medium and long-term priorities for the development of paediatric antituberculosis drugs and formulations.

On the second day, after providing additional background information on the PADO for HIV processes and priority list, participants broke up into three groups to discuss short/medium and long term priorities for a) treatment of drug-susceptible TB; b) treatment of drug-resistant TB; and c) treatment of latent TB infection (LTBI – both drug-susceptible [DS-TB] and drug-resistant TB [DR-TB]). A summary of the agreed priorities can be found in executive summary of the meeting report. This prioritization exercise was an important step towards development of and access to the most effective and safest medications in affordable, child-friendly formulations needed to reach the UN General Assembly High Level Meeting on TB targets for treatment and prevention in children.


The Sentinel project updated their Field Handbook to provide implementation advice on the new WHO Guidelines for Multi-Drug and Rifampin-Resistant Tuberculosis (available at https://www.who.int/tb/publications/2018/WHO.2018.MDR-TB.Rx.Guidelines.prefinal.text.pdf). This Field Handbook was developed by a global team of pediatric DR-TB experts, including several Child and Adolescent TB Working Group members and aims to provide practical advice for practitioners, programmes and policy makers on how the new WHO recommendations can be used to improve treatment for children with DR-TB. For more information on the Sentinel project, visit http://sentinel-project.org/.


2018 Annual Meeting

The Child and Adolescent TB Working Group met on 24 October to share country experiences and global developments, including the recently launched Roadmap towards ending TB in children and adolescents. The focus of this annual meeting was on contact investigation and preventive therapy. The meeting was attended by over 180 participants representing a broad range of stakeholders including paediatricians, NTP managers and childhood TB focal points from the NTP, Maternal and Child Health representatives, technical and financial partners, community TB representatives, and WHO staff from headquarters, Regional and Country offices.

Final Report, Presentations


Committing to ending TB in children, adolescents and families, 24 September 2018

On the eve of the 73rd UN General Assembly, UNICEF, WHO and the Stop TB Partnership hosted a side-event to show commitment and accelerate action towards ending TB in children, adolescents and families. Co-sponsored by the Permanent Mission of Japan to the United Nations, the Danish Ministry of Health, the Permanent Mission of Nigeria to the United Nations, TB Alliance, Louder Than TB, Treatment Action Group, Unitaid, the Global Fund, USAID, Elizabeth Glaser Pediatric AIDS Foundation, JHPIEGO, The Union, KNCV Tuberculosis Foundation and Every Woman Every Child, the event aimed to show commitment and accelerate action towards ending TB in children, adolescents and families. Leaders and people affected by TB discussed the importance of targeted commitments for children and adolescents. During the event the new Roadmap towards ending TB ieventn children and adolescents was launched as well as two accompanying documents: Best practices on child and adolescent TB care; and, Research priorities for paediatric tuberculosis.


Logo for the Child and Adolescent TB Working Group

As of September 2018, the Child and Adolescent TB Working Group has their own logo.