Cape Town - A news medical trial in childhood tuberculosis (TB) treatment could see treatment time shortened in South Africa from six to four months.
Stellenbosch University - together with research institutions in Uganda, Zambia and India - will participate in the Shorter Treatment for Minimal TB in Children (Shine), a programme initiated by the British Medical Research Council.
It is a randomised trial of therapy to shorten minimal TB with World Health Organisation-recommended doses of drugs in HIV-positive and HIV-negative children aged 16 or younger, and will be launched next year.
Cities that will participate in the Shine trial include Cape Town, Lusaka in Zambia, Kampala in Uganda and Chennai and Pune in India.
Anneke Hesseling, director of the Paediatric TB Research Programme at the Desmond Tutu TB Centre at Stellenbosch University’s Department of Paediatrics and Child Health, said the trial would include 1 200 children, of whom 250 would be from Cape Town.
The experimental arm will be a standard daily first-line anti-TB treatment for 16 weeks, with medication set according to revised WHO dosage recommendations. It includes an intensive eight weeks of medication that includes the following components: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), with or without Ethambutol (E), according to local practice, and HRZ(E), followed by a continuation of eight weeks HR.
“There is a huge burden of TB among children in South Africa. The cases that aren’t reported are often babies or children who may have died, or who have tended to have severe forms of TB such as TB meningitis,” Hesseling said.
In the past, the number of cases were under-estimated, Hesseling said. “To see these kind of numbers is a huge advance. Although it sounds negative, you need to know something to do something about it.”
According to a WHO TB report, in 2014 TB killed 890 000 men, 480 000 women and 140 000 children worldwide. In the last year 4 077 children in the province were admitted to TB hospitals and 8 615 were treated as outpatients.
Provincial Health Department spokesperson Mark van der Heever said the 2012 mortality Surveillance Report showed that HIV and TB were the leading causes of premature mortality in the province. TB ranks alongside HIV as a leading killer worldwide, claiming the lives of 1.2 million people annually. Close to one million people in the world living with HIV were given TB preventive therapy last year. More than half - 59 percent - were in South Africa. Hesseling said about 40 000 cases of childhood TB were reported in South Africa in 2013.
Health Minister Aaron Motsoaledi recently called on MPs and political leaders to get behind the battle against TB and urged them to sign the Barcelona Declaration, an initiative of the Global TB Caucus. Health Department spokesperson Joe Maila welcomed the Shine initiative
Cape Times
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