Effectiveness of a community-based approach for the investigation and management of children with household tuberculosis contact in Cameroon and Uganda: a cluster-randomised trial

Article Public, Environmental & Occupational Health

Cost-effectiveness of community-based household tuberculosis contact management for children in Cameroon and Uganda: a modelling analysis of a cluster-randomised trial

Nyashadzaishe Mafirakureva et al.

Summary: The use of community-based household contact management approach can significantly reduce child tuberculosis deaths and is considered cost-effective in this case at a willingness-to-pay threshold of $1000 per DALY averted.

LANCET GLOBAL HEALTH (2023)

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Article Microbiology

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

Karen du Preez et al.

Summary: Significant progress has been made in child and adolescent tuberculosis care over the past 15 years, despite numerous challenges. However, there is still a need for improved detection, treatment, and prevention services for children and adolescents with TB globally. Strengthening health systems and integrating TB programs with child health services are crucial to addressing the challenges.

PATHOGENS (2022)

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Review Microbiology

Child Contact Case Management-A Major Policy-Practice Gap in High-Burden Countries

Anca Vasiliu et al.

Summary: The 2021 Global TB report highlights the slow progress in detecting pediatric TB and improving preventive treatment among child contacts. This review emphasizes the importance of contact case management in low-resource settings, particularly for child contacts. Evidence suggests that community-based and patient-centered approaches can help bridge the implementation gaps. Additionally, providing child-friendly TB preventive treatment regimens offers an important opportunity for improvement.

PATHOGENS (2022)

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Article Immunology

Vikela Ekhaya: A Novel, Community-based, Tuberculosis Contact Management Program in a High Burden Setting

Alexander W. Kay et al.

Summary: Vikela Ekhaya program provided differentiated TB and HIV testing for 945 household contacts of 244 TB cases, using mobile contact management teams to screen contacts, and initiating and monitoring TPT adherence for 322 contacts in their homes. The program achieved TPT initiation rates of 98% and completion rates of 93% using community-based service delivery.

CLINICAL INFECTIOUS DISEASES (2022)

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Review Microbiology

Tuberculosis Infection in Children and Adolescents

Boris Tchakounte Youngui et al.

Summary: The burden of tuberculosis (TB) in children and adolescents is still significant. Each year, several million children and adolescents are infected with TB after exposure to an infectious TB case, and they have a higher risk of progressing from TB infection to tuberculosis disease compared to adults. This article reviews the risk factors for TB infection in children and adolescents, as well as the recommended approaches for diagnosis and treatment of TB infection.

PATHOGENS (2022)

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Article Multidisciplinary Sciences

Effect of patient-delivered household contact tracing and prevention for tuberculosis: A household cluster-randomised trial in Malawi

Kruger Kaswaswa et al.

Summary: Household contact tracing plays an important role in TB screening and preventive therapy. This study investigated a novel model using a household-centered patient-delivered symptom screen and IPT eligibility assessment to improve uptake. The results showed that this model significantly increased the proportion of children under 5 years receiving timely TPT.

PLOS ONE (2022)

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Article Medicine, Research & Experimental

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

Anca Vasiliu et al.

Summary: This study aimed to assess the feasibility of a community intervention for tuberculosis (TB) household child contact management in Cameroon and Uganda. Through analyzing the recruitment capability, acceptability of the intervention, and its adaptation, integration, and resources in existing TB services, the study found that the community intervention is feasible and can improve the management of household child contacts with TB.

PILOT AND FEASIBILITY STUDIES (2022)

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Article Medicine, Research & Experimental

Community intervention for child tuberculosis active contact investigation and management: study protocol for a parallel cluster randomized controlled trial

Anca Vasiliu et al.

Summary: This study aims to evaluate the impact of a community-based intervention on household child contact screening and management of TB preventive therapy in order to improve care and prevention of childhood TB in low-resource high-burden settings.

TRIALS (2021)

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Review Immunology

Symptom-based Screening Versus Chest Radiography for TB Child Contacts: A Systematic Review and Meta-analysis

Anca Vasiliu et al.

Summary: Our study found that for child contacts under 5 years, a negative symptom-based screening is sufficient to exclude active TB, while a chest radiograph should be considered for child contacts aged 5-14 years. Despite the low concordance between symptom-based screening and chest radiography, most children without TB suggestive symptoms did not have chest radiography findings suggestive of TB.

PEDIATRIC INFECTIOUS DISEASE JOURNAL (2021)

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Article Infectious Diseases