Quality matters: Redefining child TB care with an emphasis on quality

Farhana Amanullah; Jason Michael Bacha; Lucia Gonzalez Fernandez; Anna Maria Mandalakas

doi:10.1016/j.jctube.2019.100130

Quality matters: Redefining child TB care with an emphasis on quality

J Clin Tuberc Other Mycobact Dis. 2019 Nov 2:17:100130. doi: 10.1016/j.jctube.2019.100130. eCollection 2019 Dec.

Authors

Farhana Amanullah^{1

2}, Jason Michael Bacha^{3

4

5}, Lucia Gonzalez Fernandez^{5

6}, Anna Maria Mandalakas⁵

Affiliations

¹ The Indus Hospital, Department of Pediatrics, Korangi Crossing, 4th Floor IHRC, Karachi, Pakistan.
² Interactive Research and Development, Pakistan.
³ Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States.
⁴ Baylor College of Medicine Children's Foundation-Tanzania, Mbeya, Tanzania.
⁵ The Global Tuberculosis Program, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.
⁶ The International AIDS Society. Geneva. Switzerland.

Abstract

Children have been neglected in the fight against tuberculosis (TB) for decades. Despite being the number one infectious disease killer, TB does not feature on the child survival agendas partly due to absent and inaccurate data. Quality is a missing ingredient in TB care in children, yet high rates of unfavorable TB outcomes highlight its importance in this age group. Quality care is particularly important for TB affected children in the absence of a point of care sensitive and specific diagnostic test. Using the current models of child TB care, it will take another 200 years to end TB. Without focusing on the quality of child TB care, the ambitious country specific United Nations High Level Meeting for TB targets will carry minimal impact. High TB burden countries must also adopt Universal Health Care (UHC) and ensure that quality TB care is made free and equitable for all children, adolescents and their affected families. We advocate for the importance of evaluating the quality of child TB care, and provide a basic framework for quality in child TB with special attention given to creating differentiated service delivery models for children and families affected by TB.

Keywords: Children; Quality care; TB/HIV; Tuberculosis.