The Roll-out of Child-friendly Fixed-dose Combination TB Formulations in High-TB-Burden Countries: A Case Study of STEP-TB

Lena Faust; Kawsar Abdi; Kristin Davis; Chen He; Caitlin Mehrotra; Emilie Stibolt

doi:10.2991/jegh.k.190812.001

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Volume 9, Issue 3, September 2019, Pages 210 - 216

The Roll-out of Child-friendly Fixed-dose Combination TB Formulations in High-TB-Burden Countries: A Case Study of STEP-TB

Authors

Lena Faust¹^{, 2}^{, *}, Kawsar Abdi³, Kristin Davis⁴, Chen He¹^{, †}, Caitlin Mehrotra⁵, Emilie Stibolt⁶

¹Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Canada

²McGill International TB Centre, Canada

³School of Human Nutrition, McGill University, Canada

⁴Department of Microbiology and Immunology, Faculty of Medicine, McGill University, Canada

⁵Department of Pharmacology, McGill University, Canada

⁶Department of Geography, McGill University, Canada

^†

Lady Davis Institute for Medical Research, Jewish General Hospital, Canada

^*Corresponding author. Email: lena.faust@mail.mcgill.ca

Corresponding Author

Lena Faust

Received 11 April 2019, Accepted 7 August 2019, Available Online 29 August 2019.

DOI: 10.2991/jegh.k.190812.001 How to use a DOI?
Keywords: Pediatric tuberculosis; fixed-dose combinations; impact evaluation; Kenya; STEP-TB
Abstract: Childhood tuberculosis (TB) has hitherto been treated through estimation of pediatric doses through the crushing of adult pills, but the bitter taste of the pills and the inaccuracy of this dosing method presents a challenge for both patients and healthcare providers, leading to poor treatment outcomes. The TB Alliance therefore launched the Speeding Treatments to End Pediatric-Tuberculosis (STEP-TB) project to incentivize the introduction of pediatric Fixed-Dose Combinations (FDCs) of TB drugs. This case study describes the elements of this project, evaluates its impact, and highlights future challenges for pediatric TB treatment. The impact assessment incorporates both market impact as well as projected public health impact, evaluating the availability, affordability, and quality of the FDCs, and lastly providing a projection of lives saved as a result of scale-up of the FDCs to near-universal availability and utilization, based on a publicly available pediatric TB-specific model. STEP-TB resulted in the development of two child-friendly FDCs that were successfully brought to market and made available in 20 of the project’s 22 high-burden countries. On the basis of a country-specific projection of pediatric TB mortality in Kenya, scale-up to near-universal availability and utilization of the new FDCs could reduce pediatric TB-associated mortality by 2660 cases over the next 5 years. Future challenges include maintaining affordable prices for the FDCs and considering mechanisms to incentivize their introduction among high-risk groups in low-burden countries.
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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<Previous Article In Issue

Journal: Journal of Epidemiology and Global Health
Volume-Issue: 9 - 3
Pages: 210 - 216
Publication Date: 2019/08/29
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.2991/jegh.k.190812.001 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

ris enw bib

TY  - JOUR
AU  - Lena Faust
AU  - Kawsar Abdi
AU  - Kristin Davis
AU  - Chen He
AU  - Caitlin Mehrotra
AU  - Emilie Stibolt
PY  - 2019
DA  - 2019/08/29
TI  - The Roll-out of Child-friendly Fixed-dose Combination TB Formulations in High-TB-Burden Countries: A Case Study of STEP-TB
JO  - Journal of Epidemiology and Global Health
SP  - 210
EP  - 216
VL  - 9
IS  - 3
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.190812.001
DO  - 10.2991/jegh.k.190812.001
ID  - Faust2019
ER  -

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