Stop TB Symposium on "Meeting the unmet needs of women and children for TB prevention, diagnosis and care: expanding our horizons"

Wednesday 26 October 2011 in Lille, France:

Although the exact magnitude of tuberculosis (TB) among women and children is not known, the evidence is growing that they are disproportionally affected (1, 2).

Recent studies have shown that TB is an important cause of maternal mortality, particularly in women with TB/HIV, and that there is an increased risk of transmitting TB and HIV to infants born to mothers with TB/HIV (3, 4).

Confirmation of diagnosis of TB among young children is challenging. However, various initiatives around the world have come up with innovative approaches (5).

In addition, public health programs, traditionally focussing on cutting transmission, have not given much attention to tuberculosis in children as young children are not infectious.

The purpose of the Stop TB Symposium 2011 was therefore to highlight the unmet needs of women and children and to advance TB prevention, diagnosis and treatment among women and children by ensuring mainstreaming of TB diagnosis and treatment in Mother and Child Health (MCH) services.

Specific objectives of the Stop TB Symposium included:

  • To identify barriers and challenges including recording and reporting
  • To share experiences and lessons learnt from MCH services diagnosing and treating Tuberculosis
  • To define the way forward to improve prevention, diagnosis and treatment of Tuberculosis among women and children.


  1. Getahun H, Gunneberg C, Granich R, Nunn P. HIV associated TB: the epidemiology and the response. Clin Infect Dis; 2010: 15;50 Suppl 3:S201-7
  2. Hesseling A.C et al. High incidence of tuberculosis among HIV-infected infants: evidence from a South African population-based study highlights the need for improved tuberculosis control strategies. Clin Infect Dis 2009
  3. Gupta A. et al. Maternal tuberculosis: a risk factor for mother-to-child transmission of human immunodeficiency virus. J Infect Dis. 2011
  4. Gupta A. et al. Postpartum tuberculosis incidence and mortality among HIV-infected women and their infants in Pune, India, 2002-2005. Clin Infect Dis.2007
  5. Nicol M.P., Zar H.J. New specimens and laboratory diagnostics for childhood pulmonary TB: progress and prospects. Paediatr Respir Rev.2011


Part I. Global TB Control Progress

Dedication Stop TB Symposium 2011 - Mario Raviglione.pdf
Global TB Control current status - Katherine Floyd.pdf
Reducing mortality by integrating maternal and child health services - Robert Gie.pdf

Part II. Women and Tuberculosis

Diagnosis and Treatment of TB in HIV positive women - Amita Gupta.pdf
Integrating TB case finding into maternal health services - Stacie Stender.pdf
Prevent and Combat M-XDR-TB in WHO European region 2011-2015 - Massoud Dara.pdf

Part III. Children and Tuberculosis

Improving TB case detection in children at community level - Khurshid Talukder.pdf
Improving case detection in children TB REACH experience Yemen - Najla Al-Sonboli.pdf
Operational challenges in implementing IPT in children - Mohammed Yassin.pdf
IPT in children in Brazil - Clemax Couto Sant'Anna.pdf

Part IV. Addressing the unmet needs of women and children for TB prevention, diagnosis and care: expanding our horizons

Overcoming challenges in access to TB drugs for children - Gregory Kearns.pdf
Use of Xpert MTB RIF to diagnose TB in children - Mark Nicol.pdf

International Meeting on Childhood Tuberculosis, 17-18 March 2011, Stockholm, Sweden

The European Centre for Disease Prevention and Control (ECDC), jointly with the Stop TB Partnership's Childhood TB Subgroup, organized an international meeting on childhood tuberculosis, in a joint effort to highlight the current situation and to move the agenda forward in order to achieve a concerted advocacy approach and to hear the voice of the children.

The meeting was held on 17-18 March 2011 in Stockholm and was attended by a wide range of participants, including researchers, paediatricians, community representatives, civil society organizations, staff from ECDC, WHO/HQ and WHO/EURO.

The objectives of the meeting were to:

  • Identify and highlight the gaps, challenges and needs in childhood TB control.
  • Prepare the scientific rationale for the need of advocacy and to identify the key areas where more advocacy and targeted engagement with stakeholders is needed.
  • Reach a consensus on how to advocate for childhood TB control in light of the MDG 4 for child survival and how to bring forward the voice of the children.

Detailed programme of the meeting, with all presentations can be found at ECDC website

At the end of the meeting a call to action was launched and it was posted for signature of individuals for 10 days after the meeting. The final call to action is available on the Stop TB Partnership website and we encourage you to sign up here.

The TB crisis in children

More research needed on TB diagnostic tests in children: high-quality studies can pave the way

Report from the TDR meeting on childhood TB diagnostics

RAPID ADVICE: Treatment of tuberculosis in children

Post-Graduate course on Management of childhood TB in low-intermediate burden settings 5th Union Europe Region Conference, 27 May 2009, Dubrovnik, Croatia

The first ever post-graduate course on Management of childhood TB in low-intermediate burden settings was held during the recent Union Europe Region conference in Dubrovnik, Croatia.

Rationale: Because of children’s high vulnerability to TB morbidity and mortality, awareness of tuberculosis control among the paediatric population should remain high even in low-intermediate burden settings. Particularly, the relative high incidence among children belonging to highly TB vulnerable populations –such as migrants from high burden countries and the lower socio-economic groups- calls for a focus on measures to prevent and control the disease among these groups. This epidemiological setting is further complicated by the uncertainties and difficulties around paediatric TB diagnosis and management.

Learning Objectives: (1) To provide an overview of the childhood TB situation in low intermediate burden settings particularly in Europe (2) To inform participants on current state of the art diagnostic, treatment and preventive interventions. (3) To inform participants on current challenges and controversies in the management of childhood TB in low-intermediate burden settings.

The course was attended by 24 participants and the group was a mixture from Western European, low burden countries and eastern European medium and high burden countries (especially from countries with high rates of MDR-TB among the adult patients). The course discussed both clinical and epidemiological areas. Two "controversial" topics on BCG and use of IGRAs were also presented. The course was interactive with good discussion that identified some areas requiring more evidence, mostly in the field of MDR-TB treatment (such as the use of fluoroquinolones in children with active TB) and diagnosis of latent TB infection with the use of IGRAs.