The annual meeting of the Child and Adolescent TB Working Group took place as a virtual meeting on Tuesday 29 November 2022. The meeting was open to all members of the working group and other interested stakeholders and participants included paediatricians, NTP managers and childhood TB focal points in the NTP, MCH representatives, technical and financial partners, community and civil society representatives and WHO staff from headquarters, regional and country offices. 

The objectives of the 2022 annual meeting were to provide an update on the burden of TB in children and adolescents and give a brief update on recent WHO policy developments with relevance to children and adolescents; to discuss experiences, challenges and opportunities, regarding implementation of TB screening, contact investigation and prevention; to share ongoing modelling studies relevant to children and adolescents; to provide an overview of studies and share perspectives on TB during pregnancy and the post-partum period; and, to share and discuss early experiences with the implementation of the 2022 WHO guidance on the management of TB in children and adolescents.

A total of 232 registrations were received, and 148 participants attended the meeting. The meeting was divided into two sessions, from 10am to 1pm and from 2.30 to 5pm CET. Both sessions were recorded to provide members from around the world the opportunity to listen to all presentations and discussions.

Dr Tereza Kasaeva, Director of the WHO Global Tuberculosis Programme (GTB), opened the meeting and warmly welcomed all participants. She mentioned the wide dissemination of the new guidelines and operational handbook and requested the continued support of working group members in programme reviews, updates of national guidelines and national strategic plans as well as development of funding applications. She also highlighted the preparations for the second United Nations high-level meeting on TB in 2023, and the plans to update the 2018 Roadmap towards ending TB in children and adolescents. 

Farhana Amanullah, Chair of the Child and Adolescent TB Working Group, gave the report from the chair on the activities of the working group since the last meeting in November 2021. Annemieke Brands and Sabine Verkuijl from the WHO secretariat provided an update on dissemination efforts of the new WHO guidance, other relevant policy guidance, priorities for 2023 and progress towards the UNGA HLM on TB targets, including a detailed analysis of data included in the 2022 Global tuberculosis report and global TB database. Tauhid Islam from WHO GTB gave an overview of the updated guidance for national strategic planning for TB, as well as for conducting TB programme reviews. This was followed by a presentation to share the experiences of the recent programme review in the Democratic Republic of Congo (DRC) by Ramatoulaye Sall. 

During the second part of the first session, Papy Ndjibu Tshishikani presented on behalf of Aimé Loando on the challenges and opportunities around TB screening for children and adolescents at different entry points in the health system in the DRC, based on the experiences from the CaP-TB project. Kobto Ghislain Koura shared experiences from the Union on contact investigation projects in West Africa, and Suman Majumdar spoke about screening, contact investigation and prevention in a high MDR-TB prevalent setting, emphasizing the value of community engagement, based on experiences from Papua New Guinea. This was followed by a talk on decentralization of TB case finding and TB preventive treatment (TPT) services in Indonesia by Trisasi Lestari. To conclude the session, Choub Sok Chamreun (WHO Civil Society Task Force on TB) provided perspectives from civil society on TB contact investigation and TB screening at the household level and provision of TPT. 

The second session of the meeting was divided into three parts. Part 1 focussed on modelling on TB in children and adolescents. The first presentation was given by Karen DuPreez on a modelling study on TB meningitis in children. This was followed by a presentation on a recently published modelling study to evaluate the impact of COVID-19 on TB notifications in children, by James Seddon. Pete Dodd then shared the results of a modelling study to determine the global impact of household contact management for children on the incidence of multidrug-resistant and rifampicin-resistant tuberculosis, deaths, and health-system costs in 2019. The second part of the second session focused on maternal and infant TB, in which Marian Loveday gave a presentation where she shared perspectives on maternal and infant outcomes of pregnant women treated for MDR/RR-TB, which was followed by an overview of ongoing studies on TB prevention and treatment during pregnancy by Nicole Salazar Austin. 

The third and last part of the second session included presentations on the early experiences with the implementation of the 2022 WHO guidance on the management of TB in children and adolescents. Jay Achar provided an update on the development of a generic protocol and database for external validation of the treatment decision algorithms included in the operational handbook. Lisa Obimbo shared experiences from Kenya around the implementation of TB disease severity assessment and the new TB short course treatment regimens in children. The last presentation was by Amir Muhammed Khan who provided perceptions of civil society on the implementation of the new WHO recommendations. 

In the closing session, the Chair and the Secretariat thanked all presenters and participants and acknowledged the continuing financial support for the activities of the working group from USAID through UNOPS.

The meeting agenda, recording and pdfs of the presentations for which permission to share has been provided can be accessed through the links below.

Link to recording:

https://who.zoom.us/rec/share/ta2C0gMftvnGfxepeaDL0fszu4Q3LCOluTxduA2pX3...
Passcode: 4SpYhc?. (note: this includes the dot. but no space at the end)
Please note that the meeting starts at 13s

Presentations

1. Farhana Amanullah_Ben Marais_Chair_Update_2022
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2. WHO update_CAWG annual meeting_2022
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3. Tauhid Islam_Guidance for TB NSP
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4. Rama Sall_DRC_ProgrammeReview
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5. Papy Ndjibu_DRC_Childhood TB Detection
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7_Suman Majumdar_PNG_Screening_CI_TPT
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8. Lestari_Decentralization_Indonesia
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9. Chamreun_CSTF_CI_screening
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11. James Seddon_Child TB COVID-19
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12. Pete Dodd_HHMDR
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13_Loveday_MaternalInfantOutcomes_DR-TB
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14. Nicole Salazar Austin_Maternal TB
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15. Jay Achar_AlgorithmResearch_GenericMaterials
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16. Obimbo_Kenya_short course TB regimens
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17. Amir Khan_CSTF_new WHO rec
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