A press release from the Cambodian Institute Pasteur informs us that on 5 and 6 July the Institute Pasteur and the Cambodian National Tuberculosis Control Program, as well as the TB-Speed Consortium, are organizing a national symposium. Project. The fight against the disease which was conducted from 2017 to 2022.
Difficult diagnosis of children
Tuberculosis affects about 10 million people worldwide each year, including one million children. Less than half of all cases affecting children are reported to the WHO because it is difficult to diagnose. Each year, an estimated 250,000 children worldwide die of tuberculosis, and most of these deaths occur in patients who have not been diagnosed with untreated disease.
Although Cambodia has made significant progress in the fight against tuberculosis, the incidence of tuberculosis has decreased by more than 25% between 2015 and 2020, but there are more than 45,000 cases of tuberculosis each year, of which 22% are under 14 years of age.
Improving the diagnosis to better fight tuberculosis
So improving the diagnosis of tuberculosis in children is a priority research topic. The diagnosis of tuberculosis in children comes against a number of obstacles:
- Diagnostic tools such as molecular testing are less effective in children than in adults because children are often present with fewer TB bacteria;
- Diagnosis of tuberculosis is based on sputum test, which is very difficult to collect in children,
- And alternative methods such as gastric aspiration are difficult to implement in resource-limited settings.
This explains why most children treated for tuberculosis are based on hypothetical diagnoses without microbiological confirmation. However, the clinical symptoms of tuberculosis are not very specific, especially in immunocompromised children, such as children suffering from HIV or malnutrition. However, these children are particularly at risk for this disease and are at high risk of death.
Finally, because of this diagnostic difficulty, pediatric tuberculosis management is concentrated in referral hospitals, while most sick children go to primary health care centers first.
TB Speed Research Project
In this context a research project – TB-Speed - was set up in seven countries between 2017 and 2022 with limited resources and high incidence of tuberculosis: Cambodia, Cameroon, C ডিte d’Ivoire, Mozambique, Sierra Leone, Uganda and Zambia.
The project brings together researchers, technology experts, health professionals, directors of public health programs and the private sector under the direction of the University of Bordeaux.
Working on two main lines of research, the goal was to contribute to reducing infant mortality by increasing the number of children diagnosed and treated for TB:
- Decentralization of an innovative diagnostic approach to disease at the district hospital and primary health center level
- And improving the diagnosis of the most at-risk children, i.e. those who are suffering from malnutrition, living with HIV or have severe pneumonia.
The results of the project will be presented on July 5 and 6, 2022 at a symposium organized by the Institute Pasteur du Cambos and the Cambodian National Tuberculosis Control Program, in the presence of His Excellency Professor MAM Bunheng, Minister of Health.
However, some preliminary results of the project have already been shared with the scientific community and contributed to the revision of WHO technical guidelines and operational manuals for tuberculosis, published in March 2022. Studies have made it possible to develop and evaluate algorithm tools Indicate the diagnosis and prompt treatment decision in children living with HIV or suffering from severe acute malnutrition.
Thanks to its technologically advanced components, the project has improved sample collection and processing methods to facilitate their use at the primary health center level for the diagnosis of tuberculosis.