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More focus needed on child and adolescent TB in Sub-Saharan Africa

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A review of child and adolescent tuberculosis (TB) management in nine Sub-Saharan African countries has found that all national plans include children, but more focus on adolescents with TB is needed.

The research, led by the International Union Against TB and Lung Disease (The Union), highlighted that interventions and targets for child TB were included in all countries’ national TB plans and guidelines. While only four countries included interventions and targets for adolescent TB in their plans, with two countries not including adolescent TB in their national guidelines.

However, it was found that child and adolescent diagnostic approaches, preventive therapy and treatment of drug-susceptible and drug-resistant TB were well detailed in the national guidelines.

All of the countries reported dedicated funding for child and adolescent TB, but only five received funding from their government, with most or all funding coming from external donors for the majority of countries. This could leave countries vulnerable to external forces.

Although all nine countries have included child TB in their national TB training materials, only four included adolescent TB within their training materials. However, the training curricula do not comprehensively cover all relevant topics in the management of child and adolescent TB.

The review was undertaken as part of the Sub-Saharan Africa Regional Child and Adolescent TB Centre of Excellence (COE) in 2021. The COE is a virtual platform established in 2019 by The Union, the U.S. Centers for Disease Control and Prevention and nine founding member countries: Eswatini, Ethiopia, Kenya, Malawi, Mozambique, Tanzania, Uganda, Zambia, and Zimbabwe. The COE aims to bridge policy-practice gaps in management of child and adolescent TB by fostering south-to-south learning and partnerships.

Riitta Dlodlo, Principal Investigator on the study and Senior Advisor at The Union, said: “This review has greatly improved our understanding of TB management in Sub-Saharan Africa. It is clear to see that progress has been made since the COE was established, but there is much more to do in terms of to improve and expand interventions to end child and adolescent TB in these nine countries and beyond.

“These findings have helped us identify key gaps in policy and practice, which means we can better support the countries to address their specific needs in the management of child and adolescent TB.”

The results were presented at The Union World Conference on Lung Health 2023 in Paris, France.