Anne Detjen
Devasena
Gnanashanmugam
Alan Talens
for the Child TB interest and
CCH working groups
Rationale
• Children with TB are living in the community and are
likely to initially present to primary care services
• Fa...
Guiding principles
• Focus on few simple interventions to
– increase the level of suspicion
– identify children at risk
• ...
Caring for the sick child in the community
Ask for TB contact in children
with
• HIV
• Prolonged cough
• Prolonged fever
•...
Other areas for intervention
• Household contact screening
• Infection control
• Identify potential adult TB cases in a ho...
Samira Aboubaker, iCCM Evidence Review Symposium Ghana 2014
WHO/UNICEF modules for community interventions
iCCM modules
• Revised iCCM modules will include some basic TB
and HIV interventions (TB contact)
• Pilot testing under di...
How do we make the framework more that just
another document?
• Need some pilot work
– In a TB high burden setting, how ma...
In your area of work
• Is TB an issue?
• Could it be an issue?
• Do you know of any ongoing work addressing
childhood TB a...
Thank you
Childhood Tuberculosis and Community Healthcare_Anne Detjen_5.8.14
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Childhood Tuberculosis and Community Healthcare_Anne Detjen_5.8.14

  1. 1. Anne Detjen Devasena Gnanashanmugam Alan Talens for the Child TB interest and CCH working groups
  2. 2. Rationale • Children with TB are living in the community and are likely to initially present to primary care services • Family-centered and community-based care models can be a platform to support TB case finding, contact screening, follow-up as well as advocacy and awareness • Existing frameworks and modules for community case management target diseases for which TB is a differential diagnosis
  3. 3. Guiding principles • Focus on few simple interventions to – increase the level of suspicion – identify children at risk • Basic need: referral mechanisms to next level of care that can diagnose TB in children – TB program needs to decentralize care • Potential to add more complex interventions depending on – the skills, workload of HCW and – local needs
  4. 4. Caring for the sick child in the community Ask for TB contact in children with • HIV • Prolonged cough • Prolonged fever • Severe malnutrition Refer child for presumptive TB Identification of presumptive TB for referral: • TB contact • HIV • ARI • Malnutrition • Signs/symptoms of TB/EPTB Follow-up: Child with TB contact/HIV who does not improve after treatment of ARI, malaria and/or who does not gain weight after feeding supplements should be referred as presumptive Ensure BCG was given Ask for TB contact in child with ARI, malnutrition, TB signs/symptoms
  5. 5. Other areas for intervention • Household contact screening • Infection control • Identify potential adult TB cases in a household • Treatment support • Preventive services – Education, awareness – Make sure newborns received BCG – TB in pregnant mothers
  6. 6. Samira Aboubaker, iCCM Evidence Review Symposium Ghana 2014 WHO/UNICEF modules for community interventions
  7. 7. iCCM modules • Revised iCCM modules will include some basic TB and HIV interventions (TB contact) • Pilot testing under discussion in Nigeria and Malawi • Materials will be shared and discussed during satellite session at AIDS 2014 conference in Melbourne
  8. 8. How do we make the framework more that just another document? • Need some pilot work – In a TB high burden setting, how many children are identified as TB suspects if simple questions added to iCCM algorithms? – How many children are diagnosed with TB – How many children are treated for pneumonia/malnutrition, don’t respond at follow-up and have other risk factors for TB? • Anyone interested??? • Stop TB Partnership Childhood TB subgroup has a wider network of childhood TB specialists around the world to provide technical assistance
  9. 9. In your area of work • Is TB an issue? • Could it be an issue? • Do you know of any ongoing work addressing childhood TB at the community level? • Where in your area of work would it make sense to think about addressing childhood TB – and how?
  10. 10. Thank you

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