Success in childhood TB prevention lauded

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More money is needed to tackle Koch’s bacillus, the bacteria responsible for tuberculosis. Credit: NIAID, (CC BY 2.0)

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More money is needed to tackle Koch’s bacillus, the bacteria responsible for tuberculosis. Credit: NIAID, (CC BY 2.0)

Taking a common antibiotic could more than halve children’s risk of becoming sick with multidrug-resistant tuberculosis (MDR-TB), according to findings presented at a conference on lung health this week.

It is one of many emerging breakthroughs in preventing TB, which kills about 240,000 children each year – the majority under the age of 5.

A daily dose of levofloxacin reduces the risk of MDR-TB disease in children by 56%, researchers from the Desmond Tutu TB Center at Stellenbosch University in South Africa announced at the Association for Lung Health conference in Paris on Thursday (Nov. 16) Is.

Children are particularly vulnerable to MDR-TB, a disease that has developed resistance to two or more of the first-line drugs used against it.

Because of this resistance, treating the disease can be a long and difficult process, which many patients are unable to complete. In contrast, this preventive drug comes in the form of a kid-friendly, fruit-flavored tablet, according to research funder Unitaid.

An estimated 2 million children each year become newly infected with MDR-TB, which, if not treated, leads to what is known as “active TB”, a severe and highly contagious disease that usually Affects the lungs.

“Once it progresses to active disease, multidrug-resistant TB treatment is lengthy and difficult for children and their families,” said Anneke Hessling, director of the Desmond Tutu TB Center in South Africa and principal investigator of the TB-CHAMP trial. It becomes difficult.” Stellenbosch University.

“This research provides high-quality evidence for cutting that risk in half.” He said the intervention could also bring cost savings to national health systems, by avoiding lengthy treatments.

The late-stage trial involved 1,000 healthy children who were exposed to MDR-TB in communities with a high burden of TB and MDR-TB across South Africa.

The conference also heard how a separate human trial found that three new, fully-oral, abbreviated regimens for MDR-TB were safe and effective for all populations, including children, pregnant women and people with other diseases such as HIV .

The EndTB clinical trial found that treatment time could be reduced by up to two-thirds compared to traditional treatments, which can last up to two years.

Winnie Byanyima, UNAIDS Executive Director, said only 2 in 5 people with drug-resistant TB could receive appropriate treatment in 2022, “so it is great to see these advances in the treatment and prevention of multi-drug resistant TB.”

finger prick test

Late last month researchers announced what they said could be a game-changer in detecting TB in children – a simple, rapid analytical tool.

A major reason for the high number of deaths from TB is the difficulty and delay in diagnosing the disease in children. Most TB tests for adults and children rely on the use of sputum or sputum. But small children may not produce spit up on request. Furthermore, the bacterial load in childhood TB is low and symptoms are non-specific, often contributing to misdiagnosis or failure to diagnose at an early stage.

The new diagnostic tool only requires blood from a single finger.

The study, published in Lancet Infectious DiseasesIt was led by Ludwig Maximilian University (LMU) in Munich, Germany, in collaboration with partners from South Africa, Mozambique, Tanzania, Malawi and India.

Once diagnosed, 95% of TB cases can be cured, said Laura Olbrich, an LMU medical researcher and one of the study’s authors.

“So, a test that works on fingerstick blood and can be used without much laboratory infrastructure could change the problem substantially,” Olbrich said.

Developed in partnership with American diagnostics company Cepheid and currently in the prototype stage, the tool has identified about 60% of children suffering from tuberculosis with 90% specificity or accuracy.

“This makes the test comparable or superior to all other tests that work with a biomarker (a biological measure used to detect disease characteristics),” Olbrich said.

According to pediatrician Norbert Heinrich, a co-author of the study, the advantage of the test is that the blood sample can be easily taken from the fingertip and the results are fast. “We will have the results in just an hour,” he told SciDev.Net. “For most other tests, samples must be sent to outside laboratories for analysis.”

“This study is an important step toward easier ways to detect TB in children,” said Jacqueline Achkar, MD, professor of medicine, microbiology and immunology at Albert Einstein College of Medicine and an infectious diseases physician at Motefiore Medical Center, New York. ,

“Sputum can be difficult to obtain from children… therefore, other tests with body fluids that are easier to obtain are urgently needed,” he told SciDev.Net.

WHO Roadmap

On Tuesday (November 14), the World Health Organization (WHO) launched the third edition of its roadmap towards ending TB in children and adolescents, a five-year plan to improve childhood TB prevention, treatment and care. Determines the plan.

Under the plan, by 2027, diagnostic and treatment services should reach 90% of the estimated number of people living with TB, while 90% of people at high risk of developing TB should be able to access preventive treatment.

According to WHO, TB is the second deadliest disease in the world after COVID-19, causing 1.3 million deaths in 2022. It is the leading killer of people with HIV.

It is estimated that 10.6 million people will fall ill with TB in 2022, up from 10.3 million in 2021. Most of these were from Asia Pacific and Sub-Saharan Africa.

WHO says progress has been insufficient to meet global TB targets set in 2018, driven by the pandemic and ongoing conflicts.

more information:
Toyin Omotayo Togun et al, Diagnosing childhood tuberculosis: a marathon rather than a sprint, Lancet Infectious Diseases (2023). DOI: 10.1016/s1473-3099(23)00517-0

Journal Information:
Lancet Infectious Diseases

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