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TB: WHO approves stool test, bedaquiline, delamanid, others for children

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THE World Health Organization (WHO) has approved new guidelines for managing tuberculosis in children and adolescents.

The guideline includes testing tools and using bedaquiline and delamanid for all children.

The agency approved the measures on Monday in a statement.

Similarly, the agency called for increased investments in managing the condition globally.

It said deaths from tuberculosis, otherwise known as TB, rose in 2020 for the first time in 10 years because of the COVID-19 pandemic.

Tedros Adhanom
Director-General of the World Health Organization

Besides, ongoing conflicts across Eastern Europe, Africa and the Middle East have further worsened TB for vulnerable populations, according to the WHO.

The effects of COVID-19 notwithstanding, over 4,100 people die, and close to 30,000 people fall ill with TB daily.

The WHO noted that since 2000, 66 million people who could have died from the disease were saved until COVID-19 caused a setback.

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Nigeria ranks sixth among 30 TB high burden countries in the world and has the highest burden of the condition in Africa.

The WHO, in the statement issued on Monday, further disclosed that global spending on TB diagnostics, treatments and prevention in 2020 was less than half of the global target of US$ 13 billion annually by 2022, adding that for research and development, the world needed an additional US$ 1.1 billion per yearly.

The agency said investments in TB programmes had demonstrated benefits for people with the disease and the world’s health systems and pandemic preparedness. 

It also urged nations to build on the lessons learnt from COVID-19 research and catalyse investment and action to accelerate the development of new tools, especially new TB vaccines.

Updated guidelines for the management of TB in children and adolescents 

The WHO’s new guidelines highlight new patient-centred diagnosis, treatment and prevention. 

The agency recommended that diagnostic testing includes non-invasive specimens, such as stools.

  • It recommended rapid molecular diagnostics for initial tests for TB diagnosis for children and adolescents.
  • Treatment of children and adolescents who have non-severe forms of drug-susceptible TB for four months instead of six months.
  • Treatment of children and adolescent with bedaquiline and delamanid.
  • Decentralisation and integration of TB care to allow more children and adolescents access TB care or preventive treatment closer to where they live.
Tuberculosis patient in Nigeria. Photo credit: Damien Foundation

Meanwhile, the WHO said the world might not attain the United Nation’s 2022 ‘Find.Treat.All’ target.

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The agency said the target was “at risk mainly due to lack of funding”.

It added, “Between 2018–2020, 20 million people were reached with TB treatment. This is 50 per cent of the five-year target of 40 million people reached with TB treatment for 2018-2022. During the same period, 8.7 million people were provided TB preventive treatment. This is 29 per cent of the target of 30 million for 2018-2022.

“The situation is even worse for children and adolescents with TB. In 2020, an estimated 63 per cent of children and young adolescents below 15 years with TB were not reached with or not officially reported to have accessed life-saving TB diagnosis and treatment services; the proportion was even higher – 72 per cent – for children under five years. Almost two-thirds of eligible children under five did not receive TB preventive treatment and therefore remained at risk of illness.”

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