By Agnes Kiconco

KIU, Main Campus - Every year, over a million children worldwide are diagnosed with tuberculosis (TB), with a quarter of them tragically losing their lives. In sub-Saharan Africa, the situation is particularly dire, with over 60% of children with TB remaining undiagnosed.

To combat this crisis, Kampala International University (KIU) took part in a stakeholder meeting held on Wednesday, 23rd January 2025, at Protea Hotel, Kampala. The Optimizing Childhood TB Treatment Decision Algorithms (OPTIC-TB) project brought together a consortium of institutions, including KIU, Makerere Lung Institute, the Ministry of Health, and several District Health Officers from various districts.

Present from KIU was, Dr. Umi Omar Bunu, CEO of KIU Teaching and Research Hospital (KIUTHR) who coordinated discussions on the implementation of the project, alongside other participants including Vice Chancellor – Prof Muhammed Ngoma, Dr. Mustafa Mundu – Deputy Vice Chancellor, Prof Walyeldin Elfakey of Paediatrics and Infectious Diseases, KIU & Bahri University and Dr. Gaurau Bajpai, Director Grants and Partnership.

In his opening remarks, the Vice Chancellor of KIU Prof. Muhammed Ngoma emphasized the importance of collaboration between the researchers/scientists in academic institutions, the practitioners in the health facilities as well as the Ministry of Health if we are to have a country free of T.B. He noted that pediatric T.B is one of the causes of infant mortality, and yet diagnosing it among children is a challenge. He reiterated KIU’s commitment to the OPTIC TB project and pledged cooperation and teamwork with the stakeholders. He thanked the Government of Uganda for creating an enabling environment for scientists to conduct research and looked forward to policy recommendations at the end of the project.

Launched and funded by the European Union, this groundbreaking research initiative aims to improve TB detection in children under 10 years old in Uganda and Tanzania. With a staggering €4 million in funding, the team works tirelessly to develop and implement effective Treatment Decision Algorithms (TDAs) for childhood TB.

In a TB study series presented by Paediatrician and Public Health Specialist Dr. Moorine Sekadde and Epidemiologist Geoffrey Amanya, it was noted that it is often hard to diagnose children under 10 years old.

“Diagnosing TB in children under 10 is difficult because young children often have trouble producing sputum for testing, tend to have a lower bacterial load in their bodies (paucibacillary disease), and their symptoms can be non-specific, making it challenging to distinguish TB from other common illnesses, requiring more invasive procedures to collect samples like gastric lavage, which may not be readily available in primary healthcare settings; all of these factors contribute to a higher likelihood of missed diagnoses,” Dr. Sekadde explained.

The TDAs, recommended by the World Health Organization (WHO), have shown promise in diagnosing TB in children. However, there is a pressing need for more research to validate their effectiveness in real-world settings.

Dr. Bruce Kirenga, Chief Research Scientist and founding Director of the Makerere University Lung Institute said, “These clinical trials are necessary yet very expensive because what is at stake is very high”.

The OPTIC-TB project seeks to address this knowledge gap by conducting a comprehensive study across Tanzania, Uganda, and the Democratic Republic of Congo. The team will compare the effectiveness of TDAs with standard care, identify factors influencing their implementation, and assess their cost-effectiveness.

The project's findings are expected to have a profound impact on TB diagnosis and treatment in children. By providing robust evidence on the effectiveness of TDAs, the team hopes to inform policy and enhance the adoption of these life-saving algorithms.

As the OPTIC-TB project progresses, there is renewed hope for the millions of children affected by TB in Africa. With the collective efforts of researchers, healthcare professionals, and policymakers, we can work towards a future where no child succumbs to this preventable and treatable disease.