UNION STUDY ON CHILD TB PROVIDES EXAMPLE FOR PREVENTING THE DISEASE IN HIGH-BURDEN COUNTRIES

Ansek, two years old, during a consultation with a nurse before starting TB preventive treatment as part of The Union's TITI study.

The Union released preliminary results of an observational study that used contact tracing to identify children at risk and place them on preventive treatment. This potentially saved 2,000 children under five years of age in Benin, Burkina Faso, Cameroon and the Central African Republic (CAR), from developing TB.

The TITI (Transmission Investiguée de la Tuberculose Infantile) study targeted children under five years living in a household with an adult diagnosed at participating TB clinics with smear-positive pulmonary TB. They were enrolled into the study after obtaining their parents’ informed consent and were evaluated during home and clinic visits using a standardised questionnaire, clinical examination, tuberculin skin test and chest radiography. Children free of active TB were placed on three-month preventive therapy in Burkina-Faso, Cameroon and CAR, which reduces by half the duration of the six-month isoniazid regimen used in most countries. Children in the Benin arm of the study were given a six month course of preventive therapy.

Presented during the 49th Union World Conference on Lung Health, the preliminary results of the TITI study showed that, of the 2,000 children enrolled, 90 percent started preventive therapy, with 92 percent of children completing their course of treatment. Five percent of children were diagnosed and treated for active TB.

WHO strongly recommends TB preventive therapy to children under the age of five years who are household contacts of persons with bacteriologically confirmed TB. Yet only 23 percent of an estimated 1.3 million children under the age of five years, who were household TB contacts and eligible for TB preventive therapy, actually received it, according to the WHO Global TB Report 2018. The TITI study provides a simple model for ensuring life-saving treatment reaches every child in need.