Overview

Tuberculosis affects approximately 10 million new people each year and results in over 1 million deaths. This disease disproportionately harms children, representing between 5 percent and 15 percent of all new TB cases, but a larger share of death.

An estimated 90 percent of those infected with TB live in resource-limited countries and it is thought to be the main killer of HIV-infected people. However, TB still remains an issue in industrialized nations.

In 2013, the U.S. discovered about 9,500 cases of tuberculosis with over 12% diagnosed in Texas, making TB a concern to Texas Children’s Hospital.

Children with TB remain especially difficult to diagnosis and treat for several reasons, including:

  • Difficulties in obtaining sputum samples
  • Lack of pediatric specialists in resource-limited settings
  • Need for child-friendly drug formulations
  • Treatment of co-infections, such as HIV

The Texas Children’s Global Childhood TB Program addresses barriers to care and expands services available to children with TB, both domestically and globally.

Headquartered in Houston, the Texas Children’s Global TB program operates a state-of-the-art facility in Mbabane, Swaziland, the world’s epicenter of the childhood TB fight.

Texas Children’s also collaborates on TB research with Dartmouth College (Swaziland), the International Union Against TB and Lung Disease (Uganda), the International Organization on Migration (Philippines), The University of the Philippines – Manila, University of Munich’s Mbeya Medical Research Center (Tanzania), and the Papua New Guinea School of Medicine.


Team

Dr. Anna Mandalakas
Director, Global Childhood Tuberculosis Program
Associate Professor of Pediatrics, Global & Immigrant Health

Dr. Alexander W. Kay
Associate Director, Global Childhood Tuberculosis Program
Assistant Professor of Pediatrics, Global & Immigrant Health
Swaziland Program Leader

Dr. Andrew DiNardo
Assistant Professor of Pediatrics, Global & Immigrant Health

Katherine Ngo
Project Manager, Global Childhood Tuberculosis Program

Patricia Dorman
Senior Administrative Coordinator, Global Childhood Tuberculosis Program


In-Country Site Leaders

  • Lesotho - Dr. Jill Sanders
  • Swaziland - Dr. Pilar Ustero
  • Uganda - Dr. Miriam Murungi
  • Botswana - Dr. Mogomotsi Matshaba
  • Malawi - Dr. Katherine Simon
  • Tanzania - Dr. Jason Bacha
  • Tanzania - Dr. Mercy Minde

Program

The Global Childhood TB Program leverages the complementary disciplines of TB immunology, clinical care, diagnostics, prevention, and treatment to enhance comprehensive care and support clinical and translational research. Using this model approach, the Global Childhood TB program is leading the effort to apply for NIH funding with the Ministry of Health in Swaziland serving as our primary partner. Cutting edge research will be facilitated by the clinical, radiologic, and laboratory facility in Mbabane, Swaziland. The program is coordinating a large ‘team science’ approach that includes experts in the fields of immunology, diagnostics, epidemiology, and microbiome research. Opportunities for training and education are integrated into projects to support research capacity building in Swaziland.

To further the program agenda, the program collaborates intimately with the Baylor International Pediatric AIDS Initiative (BIPAI) network and Global Health Corp physicians in strengthening the TB/HIV infrastructure; increasing capacity for translational, operational and implementation science research; and supporting the growth of junior members in developing their TB/HIV research interests. In this process, the TB Program has cultivated partnerships with departments within Baylor College of Medicine and Texas Children’s Hospital, the Ministries of Health in each host country and outside organizations. In addition to partners mentioned above, the Global TB program is collaborating on TB specific research projects with Dartmouth College (Swaziland), the International Union Against TB and Lung Disease (Uganda), the International Organization on Migration (IOM) (Philippines), The University of the Philippines – Manila (Philippines), University of Munich’s Mbeya Medical Research Center (MMRC) (Tanzania), and Papua New Guinea School of Medicine (Papua New Guinea). Dr. Mandalakas continues to serve on multiple international Child TB committees, present in numerous national and international forums, and serves as mentor for two junior members to oversee the development of their research platforms in Uganda and Swaziland. The Associate Director of the Global Childhood TB Program, Dr. Pilar Alonso Ustero is based full-time in Swaziland. Over the past year, she has presented at the International Union against Tuberculosis and Lung Disease (the Union) world conference, the World Health Organization (WHO) Childhood TB Roadmap Launch in Washington DC, and served as the WHO TB/HIV expert at the Pan-American Health Organization (PAHO) conference. Read more.


Resources

Core Curriculum

  • Mycobacterial Infections Overview
  • Introduction to Childhood Tuberculosis
  • Core Curriculum on Tuberculosis - What the Clinician Should Know: Centers for Disease Control and Prevention Overview
  • Epidemiology
  • Overview
  • International: Global Tuberculosis Control, 2011
  • Clinical Manifestations
  • Intrathoracic Tuberculosis
  • Tuberculosis of the Central Nervous System
  • Diagnosis
  • Tuberculosis Screening
  • Pediatric Tuberculosis Diagnosis
  • Interferon Gamma Release Assays
  • Testing for TB Infection and Disease: Centers for Disease Control and Prevention
  • Diagnosis of TB Disease: Centers for Disease Control and Prevention

Treatment

  • United States Recommendations: Centers for Disease Control and Prevention, 2003
  • Overview of Treatment: Centers for Disease Control and Prevention

Prevention

  • Treatment of Latent Tuberculosis Infection: Centers for Disease Control and Prevention, 2011
  • Pediatric Latent Tuberculosis Infection Therapy
  • Infection Control: Centers for Disease Control and Prevention