Due to governmental concerns of limited pediatric tuberculosis diagnostic activities in the country, we collaborated with the Botswana National Tuberculosis Programme, Centers for Disease Control and Prevention, and the Botswana-UPenn Partnership to roll-out improved diagnostic strategies for pediatric tuberculosis. An initiative to improve access to sputum induction and gastric aspirates was started in 2008. Data generated from this roll-out provided information on the burden of pediatric TB in the country, capturing the utility and safety of sputum inductions and gastric aspirates, and informed the development of a Botswana-based pediatric TB diagnostic algorithm. This project was funded by a grant from the Center for Disease Control and Prevention.
Paul Mullan, M.P.H.
Two additional TB projects involve expanding tuberculosis diagnostics for HIV-infected children in Botswana through the use of two additional methodologies. The first, microscopic-observation drug susceptibility testing, uses a relatively low technology, low cost liquid culture methodology to simultaneously grow the TB bacteria and check for drug resistance. In an era of increasing drug resistance globally, this methodology offers a sustainable, timely intervention allowing optimization of individual patient care. A second methodology will determine the utility of interferon gamma release assays, which test for immune response to TB proteins, in children in the same setting, in an attempt to augment diagnosis and targeting of preventive therapy to high-risk children in a setting with tuberculosis hyperprevalence. These projects are being funded by the Thrasher Pediatric Research Foundation Grant.
Andrea Cruz, M.D., M.P.H.