Tuberculosis screening in pediatric pneumonia patients
On March 24 each year, the World Health Organization (WHO) commemorates World Tuberculosis Day. In 2019, the WHO is highlighting the urgent need to step up action to end this epidemic. An ideal time for TB Speed, a research project coordinated by the University of Bordeaux, to launch a study on pediatric pneumonia patients in 6 countries.
March 24 (1882) marks the day when Dr. Robert Koch announced that he had discovered the bacillus that causes tuberculosis, opening the way to diagnosing and treating this fatal disease. However, almost 140 years later, tuberculosis remains the world's deadliest infectious killer. Despite the fact that the disease is preventable and curable, too many children still have no access to treatment and die quite simply from a lack of diagnosis. Specifically with combating childhood tuberculosis in mind, the TB Speedresearch project was initiated in September 2017. In line with the theme of World Tuberculosis Day 2019 - "It's time" - the TB-Speed Pneumonia study was recently launched in 6 countries: Cambodia, Cameroon, Côte d’Ivoire, Mozambique, Uganda and Zambia.
This new project envisages assessing a systematic tuberculosis detection strategy in children suffering from severe pneumonia. In such children, tuberculosis is detected only in rare cases or detected late, thus contributing to increased mortality in this already vulnerable population. The TB-Speed Pneumonia diagnostic trial will implement tuberculosis screening on hospital admission by means of a new molecular test, "Xpert Ultra", performed both on a respiratory specimen (nasopharyngeal aspirate) and on a stool specimen, immediately followed by antituberculosis treatment in the event of a positive result. This study will include 3,800 children under 5 years of age admitted to hospital with severe pneumonia.
All the children will be treated for pneumonia in accordance with the World Health Organization standard of care, which includes IV antibiotics and oxygen therapy.
Half of the children will be assigned to undergo the screening strategy, while the other half will follow the procedures conventionally applied in the hospital, thus forming the control arm of the study. The endpoint is to determine the impact of the strategy on reducing mortality in children suffering from severe pneumonia.