Meetings

2021 Virtual annual meeting

The annual meeting of the Child and Adolescent TB Working Group took place on the Zoom platform on Tuesday 30 November 2021. 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 of the 2021 annual meeting was to provide a summary of the reviews presented to the WHO Guideline Development Group on the management of tuberculosis in children and adolescents in May/June 2021, both related to the PICO (Population, Intervention, Comparator, Outcome) questions related to diagnostic approaches, shortened treatment of drug-susceptible TB in children with non-severe disease, treatment of drug-resistant TB, treatment of drug-susceptible TB meningitis and models of care; as well as to the background questions on the socio-economic impact of TB on children and adolescents & the engagement of adolescents in TB care.

A total of 292 registrations were received, and 192 participants attended the meeting. The meeting was divided into two sessions of 2.5 hours each.

On behalf of Dr. Tereza Kasaeva, Director of the WHO Global TB Programme, Farai Mavhunga opened the meeting and warmly welcomed all participants. He referred to the disproportionate impact of the COVID-19 pandemic on TB prevention and case detection among children and adolescents, which will make it even more challenging to reach the UN High Level Meeting targets related to children. He conveyed that WHO is looking forward to close and continued collaboration with all relevant stakeholders at global, regional and national levels to implement the new recommendations and operational guidance in the guidelines and operational handbook. Kerri Viney then presented the detailed objectives of the meeting as well as the agenda. Farhana Amanullah, Chair of the Child and Adolescent TB Working Group, gave the report from the chair on the activities of the working group since the last meeting in October 2020. Annemieke Brands and Sabine Verkuijl from the WHO secretariat provided an update on the upcoming WHO policy recommendations relevant to children and progress towards UNGA HLM on TB targets, including an overview of data included in the Global tuberculosis report and database 2021.

During the second part of the first session, the main findings of several reviews conducted for the 2022 WHO consolidated guidelines were presented. Leslie Enane presented the main findings of the literature review as well as best practices on the background question on optimizing care for adolescents with TB infection or disease. Salla Atkins and Delia Boccia presented the main findings of the literature review on the socio-economic impact of TB on children, adolescents and their families. Nobu Nishikiori then shared the findings of the analysis of Patient Cost Surveys. At the end of the session, two WHO Civil Society Task Force members, Amir Khan from Pakistan and Blessi Kumar from India provided community perspectives and views on active case finding for tuberculosis and on optimizing care for children and adolescents affected by TB.

The second session of the meeting was divided in three parts. Part 1 focussed on evidence reviews underlying diagnostic approaches in children. Kenneth Gunasekera shared the outcome of the evaluation of existing treatment decision algorithms using an Individual Patient Data set and also mentioned the ongoing work related to two treatment decision algorithms that will be included in the 2022 WHO operational handbook to be published alongside the consolidated guidelines (early 2022). Alexander Kay shared the evidence from the systematic review on the use of Xpert Ultra in stool and gastric aspirate for the diagnosis of pulmonary TB in children. Grace Bolie from DRC provided implementation considerations related to diagnosis of tuberculosis in children from a programmatic perspective.

In the second part of the second session, Anna Turkova provided an update on the sub-analyses of the SHINE trial. Anthony Garcia-Prats shared the results from the systematic review and individual patient data meta-analysis of children and adolescents treated for RR/MDR-TB. Giorgia Sulis presented the evidence from the systematic review on the treatment of TB meningitis.

In the third and last part of the second session, Courtney Yuen, presented the evidence from the systematic review on models of care for child and adolescent TB (decentralized care and family-centred, integrated care for case detection and provision of TB preventive treatment). Martina Casenghi provided perspectives on models of care from the Unitaid-funded CaP-TB project and Eric Wobudeya shared perspectives on models of care from the Unitaid-funded TB-SPEED project.

In the closing session, the Secretariat thanked all presenters and participants and acknowledged the continuing financial support for the activities of the working group from USAID through UNOPS.

The meeting agenda, recordings and PDFs of the presentations can be accessed through the links below.

Link to recording (N.B. Please note that the recording starts a few minutes late):

https://who.zoom.us/rec/share/WVNq3qHhgEOWPvFXMmgMxdsMs7eMcAzFtX8aLLV_iSWy7HURE8slY_Tll69YfdZU._lcoTM2BxRkhOerc

Passcode: +RmD9!7V

Presentations

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

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.

Agenda, Final Report

Presentations

2017 Annual Meeting

The annual meeting of the Child and Adolescent TB working group took place on Monday 9 October 2017 in Kigali, Rwanda in conjunction with the WHO AFRO annual review and planning meeting of reproductive, maternal, newborn, child and adolescent health and nutrition programme managers in the East and Southern African Region. The main purpose of the annual meeting is to share global developments and country experiences in scaling up the response to childhood TB and to discuss next steps to move the agenda forward. Specific objectives were to provide an update on the activities of the working group from the last annual meeting on Wednesday 26 October 2016 in Liverpool, UK; to share country experiences in scaling up childhood TB activities; including collaboration with MCH and other health services at country level; to discuss case-finding strategies that could improve early case detection as well as prevention of TB -> through contact investigation and integration of childhood tuberculosis screening into other child health services such as HIV, nutrition and the Integrated Management of Childhood Illness screening programmes; to give the WHO AFRO Task Force the opportunity to present their activities in the region; to share new initiatives that are being or will be implemented in the African region; and, to prepare for session on childhood TB during WHO AFRO MCH managers meeting of Eastern and Southern Africa.

Click here for details.

Upgrading status of sub group to Working Group

Stop TB Partnership is pleased to announce Working Group status of the Childhood TB subgroup, PPM sub group (formerly part of the DOTS expansion Working Group which is no longer functional) and the End TB Transmission Initiative (formerly TB Infection control subgroup). The Executive Committee have approved the request from the three groups and henceforth will be known as the Child and Adolescent TB Working Group, Public-Private Mix Working Group and the End TB Transmission Initiative Working Group.

2016 Annual Meeting

The annual meeting of the Childhood TB subgroup was organized on Wednesday 26 October 2016 in Liverpool, UK. The meeting focused on country experiences in scaling up the response to childhood TB and on what needs to be done to move the agenda forward. More specifically, the objectives were to: share the latest estimates of the childhood TB burden; discuss how to best operationalize the End TB Strategy; give an update on the treatment of MDR-TB in children and on progress made in linking with RMNCAH services; provide an update on the uptake of the child FDCs as well as on recent developments in preventive therapy; share experiences with respect to intensive case finding of TB in children; and, at the end of the day, the new chair of the childhood TB subgroup was announced. The meeting was attended by 120 participants representing a wide variety of stakeholders including paediatricians, NTP managers, Mother and Child Health representatives, technical and financial partners, community TB representatives and WHO staff from Headquarters, regional and country offices.

On 27 October 2016, an informal face-to-face core team meeting took place in Liverpool, UK to update each other on ongoing initiatives and activities, to agree on a vice-chair and to jointly plan for 2017.

Click here for details

2014 Annual Meeting

The annual meeting of the Childhood TB subgroup took place in Barcelona, Spain on Monday 27 October 2014. The meeting was attended by over 90 participants representing paediatricians, NTP managers, technical and financial partners, community TB representatives and WHO staff from regions and countries. This year, the meeting focused on scaling up childhood TB activities at country level with interesting experiences from Bangladesh, the Democratic Republic of the Congo, UR Tanzania, Kenya and Vietnam. Participants were also briefed on the regional activities, in particular the workshops with multiple stakeholders to prepare national action plans for scaling up childhood TB. The Chair gave an update on the work of the subgroup since October 2013 and on the plans for 2015. An update was given on progress made with the implementation of the Childhood TB Roadmap, one year after its launch. New training materials on childhood TB were announced including the WHO/Union training modules and an e-learning tool for health workers at the lower levels of the health care system that will become available soon. The TB Alliance presented progress made towards the development of childhood-friendly TB formulations that may become available during the second half of 2015. WHO gave an update on the childhood TB estimates including the work on estimating the burden of TB in adolescents. USAID presented the childhood TB landscape analysis which is currently under development in close collaboration with partners and countries. TAG shared the key messages of the 2014 TB R&D tracking report showing funding trends for R&D on paediatric TB and highlighting areas for advocacy. The meeting concluded with an update on current research focusing on new TB treatment strategies in children; an update from the Sentinel project; and, an update on significant recent research papers that have been published since the meeting in 2013.

The meeting concluded with the following action points: Bring childhood TB to STAG-TB 2015 and invite colleagues working on maternal and child health as well as HIV/AIDS to facilitate integration; Document and publish scaling up activities; Assist countries to include Childhood TB in all steps of the Global Fund New Funding Model (e.g. NTP review, National TB strategic plan, gap analysis, concept note); Encourage countries to identify national and regional champions on paediatric TB; Build and expand regional capacity to address growing requests for technical assistance in particular in light of the development, finalization and implementation of national action plans for scaling up childhood TB.

Click here for the Meeting Agenda

Click here for the meeting report

2014 Annual Meeting Presentations

2013 Annual Meeting

The annual meeting of the Childhood TB subgroup took place in Paris, France on Tuesday 29 October 2013. This year, the meeting focused on scaling up childhood TB activities at country level. The meeting was attended by some 75-80 participants representing paediatricians, NTP managers, partners and WHO staff from regions and countries. The meeting concluded with the following action points: Bring childhood TB to STAG-TB 2014 and invite colleagues working on maternal and child health as well as HIV/AIDS to facilitate integration; Document and publish scaling up activities; Assist countries to include Childhood TB in all steps of the Global Fund New Funding Model (e.g. NTP review, National TB strategic plan, gap analysis, concept note); Encourage countries to identify national champions on pediatric TB; Build and expand regional capacity to address growing requests for technical assistance; Consider to add a module on participation in programme reviews to the South Africa training course (annual workshop in Cape Town); and, Consider to include adolescents in the scope of work of the Childhood TB subgroup.

Final report Childhood TB subroup meeting Paris France 29 October 2013.pdf

Presentations

Meeting photos

Annual meeting of the Childhood TB Subgroup, Kuala Lumpur, Malaysia, 11 November 2012

The ninth annual meeting of the childhood TB subgroup was held on 11 November 2012 in Kuala Lumpur, Malaysia. The meeting was divided into two parts. The morning session discussed country-level experience in policy implementation. The afternoon session focused on the implications of the post-2015 TB strategy for the field of childhood-TB.

The purpose of this meeting was:

  • To present and discuss with the subgroup members recent developments in the area of Childhood TB including the updated guidance for national tuberculosis programmes on the management of tuberculosis in children and the steps taken towards the development of new FDCs.
  • To present the draft Childhood TB roadmap, discuss outstanding technical issues that require further input from the subgroup members, and plan the way forward (how to best assist countries in scaling up Childhood TB activities).
  • To present the work on the post-2015 TB strategy (exact name to be determined) and to discuss the implications for Childhood TB.

The meeting was widely attended by the members of the subgroup, NTP managers and other representatives from high TB burden countries, partners and WHO staff.

Past Events