Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low-and Middle-Income Countries

Karen du Preez, Betina Mendez Alcântara Gabardo, Sushil K. Kabra, Rina Triasih, Trisasi Lestari, Margaret Kal, Bazarragchaa Tsogt, Gantsetseg Dorj, Enkhtsetseg Purev, Thu Anh Nguyen, Lenny Naidoo, Lindiwe Mvusi, Hendrik Simon Schaaf, Anneke C. Hesseling, Andrea Maciel de Oliveira Rossoni, Anna Cristina Calçado Carvalho, Claudete Aparecida Araújo Cardoso, Clemax Couto Sant’anna, Danielle Gomes Dell’ Orti, Fernanda Dockhorn CostaLiliana Romero Vega, Maria de Fátima Pombo Sant’anna, Nguyen Binh Hoa, Phan Huu Phuc, Attannon Arnauld Fiogbe, Dissou Affolabi, Gisèle Badoum, Abdoul Risgou Ouédraogo, Tandaogo Saouadogo, Adjima Combary, Albert Kuate Kuate, Bisso Ngono Annie Prudence, Aboubakar Sidiki Magassouba, Adama Marie Bangoura, Alphazazi Soumana, Georges Hermana, Hervé Gando, Nafissatou Fall, Barnabé Gning, Mohammed Fall Dogo, Olivia Mbitikon, Manon Deffense, Kevin Zimba, Chishala Chabala, Moorine Penninah Sekadde, Henry Luzze, Stavia Turyahabwe, John Paul Dongo, Constantino Lopes, Milena Dos Santos, Joshua Reginald Francis, Magnolia Arango-Loboguerrero, Carlos M. Perez-Velez, Kobto Ghislain Koura, Stephen M. Graham

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Abstract

Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality—over one and a half million children and adolescents develop TB each year. A history of the global public health perspective on child and adolescent TB is followed by 12 narratives detailing challenges and progress in 19 TB endemic low and middle-income countries. Overarching challenges include: under-detection and under-reporting of child and adolescent TB; poor implementation and reporting of contact investigation and TB preventive treatment services; the need for health systems strengthening to deliver effective, decentralized services; and lack of integration between TB programs and child health services. The COVID-19 pandemic has had a significant negative impact on case detection and treatment outcomes. Child and adolescent TB working groups can address country-specific challenges to close the policy– practice gaps by developing and supporting decentralized models of care, strengthening clinical and laboratory diagnosis, including of multidrug-resistant TB, providing recommended options for treatment of disease and infection, and forging strong collaborations across relevant health sectors.

Original languageEnglish
Article number196
Pages (from-to)1-26
Number of pages26
JournalPathogens
Volume11
Issue number2
DOIs
Publication statusPublished - Feb 2022

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