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. 2022 Feb 1;11(2):196.
doi: 10.3390/pathogens11020196.

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

Karen du Preez  1 , Betina Mendez Alcântara Gabardo  2   3 , Sushil K Kabra  4 , Rina Triasih  5 , Trisasi Lestari  5   6 , Margaret Kal  7 , Bazarragchaa Tsogt  8 , Gantsetseg Dorj  9 , Enkhtsetseg Purev  10 , Thu Anh Nguyen  11 , Lenny Naidoo  12 , Lindiwe Mvusi  13 , Hendrik Simon Schaaf  1 , Anneke C Hesseling  1 , Andrea Maciel de Oliveira Rossoni  2   3 , Anna Cristina Calçada Carvalho  2   3   14 , Claudete Aparecida Araújo Cardoso  2   3 , Clemax Couto Sant'Anna  2   3 , Danielle Gomes Dell' Orti  2 , Fernanda Dockhorn Costa  2 , Liliana Romero Vega  2 , Maria de Fátima Pombo Sant'Anna  2   3 , Nguyen Binh Hoa  15 , Phan Huu Phuc  16 , Attannon Arnauld Fiogbe  17   18 , Dissou Affolabi  18   19 , Gisèle Badoum  17   20   21 , Abdoul Risgou Ouédraogo  17   20   21 , Tandaogo Saouadogo  21 , Adjima Combary  17   22 , Albert Kuate Kuate  17   22 , Bisso Ngono Annie Prudence  22 , Aboubakar Sidiki Magassouba  17   23 , Adama Marie Bangoura  23 , Alphazazi Soumana  17   24 , Georges Hermana  17   25 , Hervé Gando  25 , Nafissatou Fall  17   26 , Barnabé Gning  26 , Mohammed Fall Dogo  17   27 , Olivia Mbitikon  17   25 , Manon Deffense  17 , Kevin Zimba  28 , Chishala Chabala  29   30 , Moorine Penninah Sekadde  31 , Henry Luzze  31 , Stavia Turyahabwe  31 , John Paul Dongo  32 , Constantino Lopes  33 , Milena Dos Santos  34 , Joshua Reginald Francis  6 , Magnolia Arango-Loboguerrero  35 , Carlos M Perez-Velez  36 , Kobto Ghislain Koura  17   37   38 , Stephen M Graham  17   39
Affiliations

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

Karen du Preez et al. Pathogens. .

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 decentral ized 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.

Keywords: adolescent; child; national tuberculosis program; tuberculosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Global milestones related to TB in children and adolescents, 2011–2020. Reprinted from Ref. [4].
Figure 2
Figure 2
Percentage of new and relapse TB cases that were children (aged <15 years) in 2019. Reprinted from Ref. [4].
Figure 3
Figure 3
Seven key policy recommendations for NTPs as listed in the “Call to action to DEFEAT childhood TB.” Adapted from Ref. [100]. These actions are consistent with the roadmap [14] and can guide child TB working groups to define the next steps to address remaining country-specific challenges to address the policy–practice gaps that this article highlights by providing detailed perspectives and country-specific updates from a wide range of settings, for the first time, on efforts to address child and adolescent TB.
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