Indian paediatricians to be trained in managing childhood TB.

The Indian Academy of Pediatrics has announced a new initiative to train paediatricians across the country in the management of childhood tuberculosis. The academy is working in partnership with the Child TB Division of the Ministry of Health and Family Welfare and the Revised National Tuberculosis Control Program to develop a two day, case based interactive module to standardise the management of childhood tuberculosis across India. In an article, published in the 15 April issue of Indian Pediatrics, the academy’s national president, Vijay Yewale, said, “The pediatric TB and its drug resistance situation in India can be viewed as a ticking time bomb. Taking serious note of this emerging health crisis, the Academy has decided to lay a significant focus on intense training of its members in case detection, timely diagnosis, ensuring adherence, monitoring adverse effects, and appropriate timely referral to experts for dealing multidrug-resistant disease. Our national strategy needs to prioritize pediatric TB with a uniform access of quality of diagnosis and care.” Last year the World Health Organization said that a child with tuberculosis was as likely as an adult with tuberculosis to have the multidrug resistant form of the disease (MDR-TB). “It is estimated that anywhere between 10 000 and 20 000 children in India might be acquiringMDR-TB every year,” said Yewale in the article. International experts have welcomed the academy’s initiative. Madhukar Pai, associate director at theMcGill International TB Centre in Montreal, Canada, said that it was important for professional societies and the private sector to work closely with the Revised National Tuberculosis Control Program to find a solution for all patients with tuberculosis, especially children. He told the BMJ, “There is considerable confusion about the diagnosis and management of childhood TB in India, and practices in the private sector often tend to deviate from national and international standards. By providing IAP [Indian Academy of Pediatrics] members a standardised training, there is great scope to align practices with the international standards for TB care and with the recently published standards for TB care in India.” Jeffrey Starke, director of the Tuberculosis Clinic at Texas Children’s Hospital in the United States, said that as India had the highest burden of adult tuberculosis in the world it was likely that it also had the highest burden of childhood tuberculosis. He told the BMJ, “Accurate counting of childhood TB cases all over the world is hampered by difficulty in microbiologically confirming the diagnosis, lack of reporting or proven and suspected cases, and lack of recognition of the disease in children. Any initiative that educates clinicians who care for children will have great benefits and should be applauded.”