Children living with TB and HIV

[Guest guest]

Children living with TB and HIV

Children living with TB and HIV are particularly neglected

The most neglected of all those suffering from TB and/or HIV are

children.

HIV cannot be diagnosed in infants without expensive, complex medical

equipment. Even when they do not have HIV, the problems of diagnosing

TB are greater in children than in adults. It is rare to achieve a

definitive diagnosis of TB in co-infected children without equipment

that, for most, is out of reach.

" In 1994 we started TB treatment for undernourished children. Young

children do not produce sputum and the diagnosis had to be entirely

based on clinical judgement. " — Dr uis, MSF Head of

Mission and Medical Coordinator, Myanmar.

Children with TB and HIV develop disease more quickly and die more

quickly. The drugs needed to treat both TB and HIV are not available

in child-friendly palatable liquid forms, nor are tablets small

enough for young children to swallow. When drugs are available they

are often very expensive.

MSF is increasingly focused on getting children with HIV and TB onto

treatment but globally far too little is being done. National

programmes neglect children, or leave them until adults are treated.

Drug companies see no profit in researching better diagnostic tools

or drugs for children in poor countries.

http://www.msf.org/source/annual/tbday/2007/tb-hiv-failure-to-act.pdf

[Guest guest]

Dear FORUM,

Subject: Re: Children living with TB and HIV

/message/7122

Diagnosis of TB in children with and without HIV is a complex matter becuase of

the inability of children to produce sufficient sputum and the possibility of

extrapulmonary TB in those who are HIV positive.

The lab diagnosis has to be done through TB cultures.

Coventional LJ media used in solid cultures takes almost 6 weeks to

produce the results which in many cases may be too late for HIV positive

children.

However there is equipment available through which it is possible to reduce the

time taken to grow the bacteria.

These are possible through enriched media on automated and semiautomated

equipment which can produce positive results in less than 2 weeks.

Speedy diagnosis can help in the timely provision of medication and thus prevent

needless mortality.

Sanjay Sarin

e-mail: <ssarin_2000@...>