•According to the Ministry of Health’s Division of National TB Leprosy and Lung Disease Programme, child and adolescent TB is often overlooked by health care providers as it is difficult to diagnose and treat.
•The programme says Kenya has given higher priority to children with TB even though they are less likely to transmit the disease.
Image: OZONE
Kenyan children at risk of tuberculosis will benefit from a new formulation, that carries probably the lowest price in the market.
The formulation was already available in Kenya but for adults.
Donors this week announced the new formulation will reach the market at a price of between Sh1,000 and Sh2,500, depending on the weight of a child.
The medication contains a new formulation of rifapentine (P), which has been approved for tuberculosis (TB) prevention combination treatment options known as 3HP.
The combination also contains child-friendly formulation of isoniazid (H).
The treatment is a three-month oral treatment taken once weekly.
The donors funding the new formulation, Unitaid-funded IMPAACT4TB Consortium, led by the Aurum Institute, said the affordable price also means that 3HP treatment in children is now cheaper than alternative TB preventive treatments available for children.
This is the first time low- and middle-income countries will avoid a higher price per tablet for a paediatric TB formulation, they said.
"Children deserve access to the same life-saving medicine to prevent TB as adults," Clinton Health Access Initiative CEO Dr Neil Buddy Shah said in a statement.
National coordinator of Stop TB Partnership Kenya Evelyne Kibuchi said this is an exciting moment for Kenya.
"The problem is that we don't have a national fund to roll out the new formulation, which is essential for children below 15 years. We need to roll out this formulation urgently for children exposed to adults with bacteriologically confirmed TB," she said.
According to the Ministry of Health’s Division of National TB Leprosy and Lung Disease Programme, child and adolescent TB is often overlooked by healthcare providers as it is difficult to diagnose and treat.
The programme says Kenya has given higher priority to children with TB even though they are less likely to transmit the disease.
In Kenya, 5,663 childhood TB cases were notified to the programme in 2021, representing eight per cent of all notified cases against a national target of 10 per cent-15 per cent.
The risk of rapid progression from TB infection to active disease is high, particularly in young children (0-5 years), and they often get severe forms of TB.
Other groups of children who are highly vulnerable to get severe forms of TB are those who are malnourished, HIV infected or having other comorbidities.
The paediatric formulation, now available to governments and global health procurers in more than 135 countries including Kenya, is water-soluble and raspberry-flavoured, making it easy to administer and more acceptable to children.
Previously, caregivers had to cut or crush multiple, bitter-tasting pills in an attempt to achieve the right dosage for children.
This made the treatment journey difficult for children and their families, contributing to treatment failure and death from the disease.
Evidence shows that short-course TB preventive treatment regimens are cost-effective; people taking shorter drug regimens are up to three times more likely to complete their course of TB prevention drugs than those on longer regimens—leading to better outcomes and more lives saved.
An assessment conducted within the project of the paediatric TB preventive treatment (TPT) market estimated that about 2.25 million children and adolescents need TPT every year due to their HIV status or based on exposure to TB within the home.
“Historically, children have been marginalised in the fight against TB. We have not developed child-appropriate medicines for prevention or treatment until long after the adult versions reach the market. This innovation levels the playing field for our next generation and keeps them healthy,” Aurum Institute group CEO Professor Gavin Churchyard said.
Unitaid said child formulations are critical but largely neglected area of child health.
“Because a fruit-flavoured, dispersible medicine can make the difference between a child taking their medicine or not, they can be transformative in the lives of children and caregivers affected by disease,” said Dr Philippe Duneton, executive director of Unitaid.
WHO currently recommends the use of 3HP in children two years of age and above.
Dosing for younger children will be reviewed by the WHO Technical Advisory Group on dosing in early 2024.