Anso Thom
The Desmond Tutu TB Centre (DTTC) at the University of Stellenbosch will receive an international award today for its groundbreaking research into childhood TB and its pioneering community-based approaches to TB and HIV care.
The $65 000 (R566 000) Kochon Prize has been awarded annually for the past six years to individuals, institutions or organisations that have made a highly significant contribution to combating TB, a disease that is curable but still causes the deaths of three people every minute.
This 2012 prize was announced at the World Health Organisation’s Stop TB Symposium, an annual event at the World Conference of the International Union Against Tuberculosis and Lung Disease.
Professor Anneke Hesseling, director of the paediatric TB programme at DTTC, accepted the award this morning in Kuala Lumpur, Malaysia.
“This prize is a wonderful recognition of our centre’s work in childhood TB over the last two decades and indicates the unique contribution made, cumulatively, by individuals in our group over the years. More importantly, this prize highlights the importance of childhood TB, which has been neglected for many decades,” Hesseling said.
She added that childhood TB levels were an indicator of “how well we are doing with overall TB-control strategy”.
TB in young children indicates recent TB transmission from adults to children, often at the household level, and is an indication of failing TB control among adults with TB, who typically transmit the organism.
Childhood TB also represents a significant burden of disease in high-burden countries such as South Africa, where almost 15 percent of all TB cases occur in children.
Since young children are more prone to severe forms of disease, such as TB meningitis, TB in young children can be very serious, causing considerable morbidity and mortality.
Hesseling believes that, for the first time, there seems to be hope in the fight against childhood TB. “We have more emphasis on childhood TB from WHO and from public health programmes, which have traditionally only focused on adult infectious TB cases.
“Developing countries are writing guidelines and are implementing care for childhood TB, while child-friendly TB drugs are being developed. New diagnostic tools are being developed; such tools should also specifically consider the needs of children, which remains a challenge,” Hesseling said.
However, a new, more effective TB vaccine was urgently needed if there was any hope of winning the battle against childhood (and adult) TB.
Several new TB vaccines are being evaluated, including in South Africa, and all these trials include children.
New drugs are being evaluated to treat drug-resistant and susceptible forms of TB in adults. There are also plans to test these and eventually make them available for children.
“The biggest current challenge for TB control in children is that we have good knowledge but implementation is lagging behind,” Hesseling added.
Asked what items she would place on a wish list, Hesseling said:
l Increased political commitment for the prevention and treatment of childhood TB at programmatic level;
l An effective and safe vaccine to prevent TB in children;
l The use of more family-friendly integrated ways to address both TB and HIV at the household and community level;
l Funding and research to generate new child-friendly, accurate TB diagnostic tests in children; and
l Effective and safe, shorter treatment regimens to prevent and treat TB in children.
Hesseling ascribes the growing international interest in childhood TB over the past five years to the fact that the HIV research community had recognised that TB and HIV were linked, and the fact that childhood TB had been placed on the international TB control and advocacy agenda.
She added that attention was also increasingly given to the design and implementation of very rigorous high-quality research for childhood TB, which was not only impacting on policy and practice, but also on the awareness of childhood TB in the international research-funding community.
“We have a long way to go in this regard but [now] there is a feeling that childhood TB is coming of age.”
Dr Lucica Ditiu, executive secretary of the Stop TB Partnership, said it was a disgrace that 200 children died of TB every day across the world.
“This is absolutely shameful, considering that we are in 2012, and it costs less than 3c a day to provide preventive treatment and 50c a day to provide treatment that will cure the disease. But children are often forgotten.
“The Desmond Tutu Centre has been at the forefront of organisations fighting to end the tragedy of TB in children,” said Ditiu.
The centre has established a number of outreach projects in areas where research is conducted, operating on the principle that research should be integrated with services delivered by the Department of Health.
It also established and runs the world’s first international childhood TB training programme.
The scientific body of work produced by the centre’s researchers includes more than 300 articles on the epidemiology, prevention, diagnosis and treatment of childhood TB. This work has engendered ten international policy documents, creating a robust evidence base for addressing childhood TB. – Health-e News Service