Two members of the Division of Global Pediatrics presented their research on tuberculosis (TB) in children during the Union World Conference on Lung Health in Paris, France, November 15–18, 2023. Tony Garcia-Prats, MD, MSc, PhD, associate professor in the Divisions of General Pediatrics and Adolescent Medicine and Global Pediatrics, is engaged in clinical and translational research that improves the prevention and treatment of TB and multidrug-resistant TB in children, especially those in resource-limited settings. He was author or co-author on seven presentations throughout the four-day event while a worldwide project he leads garnered international media attention for first-of-its-kind results from a TB prevention drug trial. Bryan Vonasek, MD, PGY-8, a member of the Garcia-Prats Research Group and a fellow in the Pediatric Infectious Diseases Fellowship, led two abstracts and organized a symposium on TB and severe acute malnutrition in children.
The Union Conference is sponsored by the International Union Against Tuberculosis and Lung Disease, which works toward the global elimination of TB. Despite being a curable and treatable disease, TB is a leading infectious disease killer worldwide: it accounted for 1.3 million deaths in 2022, 16% of them children.
Clinical trial results showed that levofloxacin safely reduced the risk of developing multidrug-resistant tuberculosis (MDR-TB) in children by more than half
A landmark clinical trial presented at the Union Conference gained international media attention. The phase III trial TB-CHAMP showed that a once-daily dose of the widely available antibiotic levofloxacin over six months cut a child’s risk of developing multidrug-resistant tuberculosis by 56%. TB-CHAMP was conducted within BENEFIT Kids, an international project that aims to improve access globally to better MDR-TB treatment and prevention for children. Garcia-Prats, a co-investigator on the TB-CHAMP trial, is principal investigator of the five-year, $20.5 million BENEFIT Kids project that is funded by Unitaid through South Africa’s Stellenbosch University. News coverage about the trial appeared online at allafrica.com, indianexpress.com, BBC Africa, Agence France Presse, and NPR, among others.
“Children affected by MDR-TB are one of the most underserved populations with TB globally,” Garcia-Prats said. “This pivotal trial has provided the much-needed high-quality evidence to impact global policy and drive demand and uptake of this safe, effective approach to preventing MDR-TB in children.”
Several other BENEFIT Kids Program studies were presented at the event. Garcia-Prats also led a symposium and presented a session detailing the preliminary work on a new initiative, “Chasing Expedited and Equitable Treatment Access for Children with TB (CHEETA) Task Force.”
Addressing tuberculosis and severe acute malnutrition in children
Vonasek recently completed a Fogarty Global Health Fellowship on-site at Lilongwe, Malawi, where he studied the diagnosis of TB in children with severe acute malnutrition. The work he presented on this topic at the Union Conference was supported by a UW Department of Pediatrics Fellow R&D Award and a Thrasher Research Fund Early Career Award.
Vonasek was first author and PI of the study highlighted in the presentation, “High Prevalence of TB among Children under Five Years Hospitalized with Severe Acute Malnutrition.” This work showed that children hospitalized with severe acute malnutrition (SAM) are at high risk for TB infection and reinforced the need for improved diagnostic strategies.
Vonasek also organized a symposium at the conference, “Another Cursed Duet of Afflictions — Tuberculosis and Severe Acute Malnutrition in Children.” He offered one of the five presentations included in that symposium: “Research Gaps for Co-Prevalent Tuberculosis and Severe Acute Malnutrition.”
“Over the past few years — with the support of excellent mentors and colleagues, but also frustrated by losing too many children I have cared for suffering TB and SAM — I developed a strong interest in this area, researching better ways to manage children who have the double threat of TB and SAM,” Vonasek said. “It was nice to share some of our early success in Paris and also to meet with experts in the field to network and discuss bigger plans to tackle these enormous challenges that unnecessarily plague children across the globe.”