Children at the Center of WHO’s Tuberculosis Guidelines

The number of tuberculosis (TB) cases has increased for the first time in over a decade. The COVID-19 pandemic and the Russia-Ukraine conflict are delaying the eradication of TB that was part of the Sustainable Development Goals (SDG) for 2030. To address this issue, the World Health Organization (WHO) published guidelines to assist those in need, specifically children and adolescents.

“Children and adolescents with TB are lagging behind adults in access to TB prevention and care,” said Tereza Kasaeva, Director, WHO Global TB Program. Children and adolescents are the ones who suffer the most amid the lack of services and medical attention regarding TB, according to the WHO. In 2020, over 50 percent of the children and adolescents who suffered from TB did not access early diagnosis or treatment. Moreover, two thirds of children under 5 years old did not receive preventive treatment regardless their of eligibility. 

To face this scenario, the WHO published guidelines to improve the treatment and attention of TB in children and adolescents. Within the guidelines rapid molecular diagnostics are recommended for both children and adolescents. Also, bedaquiline and delamanid are the newest medicines suggested to treat drug resistant (DR) TB in children. The organization also recommends the decentralization of TB treatments and non-invasive diagnostic testing. “The priority now is to rapidly expand implementation of the guidance across countries to save young lives and avert suffering,” said Kasaeva.

In 2019, 10 million people were diagnosed globally with TB and within the Americas, 289,000 cases were identified, as reported by PAHO.  During the same year, Mexico reported 19,794 new cases of respiratory TB and 4,153 cases of other forms of TB. Diabetes, malnutrition, HIV and alcoholism are the most common comorbidities of TB in Mexico, which also impede the treatment and survival of TB patients, as reported by the Federation Official Diary (DOF). In Mexico, the NOM-006-SSA2-2013, establishes and aligns the procedures, criteria and guidelines for diagnosis, treatment and attention of TB.

The SDG’s 3.3. goal aims that the epidemics of AIDS, TB, malaria, neglected tropical diseases, hepatitis, water-borne diseases and other communicable diseases are eradicated by 2030. The SDG aims to end the global TB epidemic by 2030.

However, the current war conflict between Ukraine and Russia and the COVID-19 pandemic are delaying the achievement of the SDG.  On one hand, the WHO has identified that the COVID-19 pandemic has increased the obstacles for people to access TB health services due to the prioritizing of SARS-CoV-2 diagnosis, medicine supply and treatment.

On the other hand, in Ukraine, multi-drug-resistant (MDR) TB is a public health problem. In 2018, Ukraine reported that 6,900 TB patients suffered from MDR-TB. Ukraine is one of the 20 countries with the highest estimated numbers of incident MDR-TB cases. To address this, in face of the war, the WHO is collaborating with its offices in Ukraine and neighboring countries to assist refugees and displaced people who suffer from TB. Globally, about 700,000 people die each year from MDR-TB, HIV, malaria and staph infections, as reported by MBN.