Globally, few children with drug-resistant (DR) tuberculosis (TB) are identiﬁed, diagnosed, and given an appropriate treatment. Although advances have been made in critical high burden countries such as Bangladesh to increase access to quality care and treatment for DR TB, this disease is still considered largely to be a problem for adults, and children who are infected remain too often in the shadows, unable to access care.
A child infected with TB is likely to progress to disease and death more rapidly than an adult. Drug-resistant forms of TB are also curable in children if they are found and treated promptly and correctly. However, because a diagnosis of drug-resistant TB (DR-TB) requires isolating the TB bacteria—something that is often difficult to do in children—it is a challenge to obtain a diagnosis even in a child that is very sick. Children with DR-in Bangladesh require urgent attention including developing capacities of health providers to suspect, diagnose and treat pediatric DR TB cases.
The USAID TB CARE II project has focused heavily on strengthening systems of care throughout Bangladesh to tackle both DR TB, including decentralizing treatment to increase availability of care in more communities, and pediatric TB, by working with counterparts in the Ministry of Health to develop the first National Guideline on Pediatric TB and training health providers at all levels to find and treat child TB cases. With the help of partners at all levels, important successes have been made in both areas.
An important opportunity exists now in Bangladesh to lay a foundation to address the critical remaining gap in the provision of services for pediatric DR TB. Although challenging, the goal of achieving zero TB deaths requires taking a long-term view and identifying key short-term steps which can be taken to raise awareness and capacity in this area. To this end, the TB CARE II project has teamed up with the Sentinel Project on Pediatric Drug-Resistant Tuberculosis, a global partnership which was formed in 2011 as a network of experts and stakeholders in childhood DRTB. Together, TB CARE II proposes to introduce an initial workshop on pediatric DR TB in Bangladesh geared at improving the diagnosis and treatment of childhood DR TB. This workshop, scheduled to take place July 15-17th 2013, will be the first step of a collaborative process to initiate activities to improve the quality of TB services provided to children in the country.