Get more Mail & Guardian
Subscribe or Login

User-friendly TB drugs for children could be on their way

Every parent knows about the battle to get toddlers to take their medication when they’re ill. Imagine the same battle, each day for six months or more, except your child has tuberculosis (TB) and could die if they don’t take their medication.

The medicine you’re trying to give them isn’t a teaspoon of strawberry-flavoured syrup, but a handful of chopped up bitter-tasting pills, made for adults. Paediatric formulations for tuberculosis drugs, are hard to come by.

The World Health Organisation (WHO) estimates that 140 000 children died of tuberculosis (TB) in 2014 – more than 380 a day.

Children respond well to treatment if the disease is diagnosed early. A paper published in the journal Clinical Infectious Diseases in 2010, found that at least 90% of children with ordinary (drug-susceptible) TB are cured. But it isn’t always easy to get them to take their medicine.

“Some of the tablets taste very bad, and need to be crushed and broken. [If they have drug-resistant TB] there are also injections, which are painful. It’s really not patient friendly,” says Anneke Hesseling, the director of Stellenbosch University’s Desmond Tutu TB Centre.

“The challenge is to make the treatment of children who have TB more family friendly. This would mean developing medicines that are easier to swallow, and making the treatment regimen shorter.”

Paediatric formulations neglected
Children with ordinary TB need to take medication for six months, but those with those with drug-resistant tuberculosis, for which the usual treatment often doesn’t work, require 12 to 18 months of treatment, including six months of injections. These children also need to be admitted to hospital.

The development of paediatric formulations of TB drugs have been neglected, although new formulations are now starting to come on to the market.

The tuberculosis advocacy organisation TB Alliance is among those who have supported the development of paediatric formulations and are trying to make it more widely available. You can watch a video explaining the problem with paediatric dosing here:

“The medicines themselves are not new,” says Hesseling, “but the individual medicines – rifampicin, isoniazid and pyrazinamide – are combined in one tablet, in a fixed-dose combination. The tablet is small, can be easily halved and dissolves in water, which is important for small babies.”

The formulation is made by the Indian drug company, McCleods Pharmaceuticals, and Hesseling says it’s hoped the tablet will soon be available for routine use in South Africa.

Trial for shorter treatment
A new trial, known as the “shorter treatment for minimal TB in children” (Shine), will look at whether doctors can shorten the treatment of drug-susceptible lung TB in children from the standard six-month regimen to four months, using a child-friendly combined tablet. The trial will be conducted in South Africa, Zambia, Uganda and India and will involve about 1 200 children.

But Hesseling says: “The most effective way to treat TB in children is to prevent it in the first place.”

Children often get tuberculosis from family members, and, although there is evidence that you can prevent children from developing the illness by treating them with isoniazid for six months, the implementation of this therapy is still very poor, Hesseling says.

Subscribe for R500/year

Thanks for enjoying the Mail & Guardian, we’re proud of our 36 year history, throughout which we have delivered to readers the most important, unbiased stories in South Africa. Good journalism costs, though, and right from our very first edition we’ve relied on reader subscriptions to protect our independence.

Digital subscribers get access to all of our award-winning journalism, including premium features, as well as exclusive events, newsletters, webinars and the cryptic crossword. Click here to find out how to join them and get a 57% discount in your first year.

Faranaaz Parker
Faranaaz Parker is a reporter for the Mail & Guardian. She writes on everything from pop science to public health, and believes South Africa needs carbon taxes and more raging feminists. When she isn't instagramming pictures of her toddler or obsessively checking her Twitter, she plays third-person shooters on Xbox Live.

Related stories


If you’re reading this, you clearly have great taste

If you haven’t already, you can subscribe to the Mail & Guardian for less than the cost of a cup of coffee a week, and get more great reads.

Already a subscriber? Sign in here


Subscribers only

Basic web lessons for South Africa: Government hacks point to...

Recent cyberattacks at the department of justice and the space agency highlight the extent of our naïveté

‘The children cannot cope any more’: Suicide in Calvinia highlights...

How Covid-19 has intensified the physical and emotional burdens placed on children’s shoulders.

More top stories

Sisters pave the way with ecobricks

The durable bricks are made from 30% recycled plastic, some of which they collect from a network of 50 waste pickers

If the inflation-driving supply strain in the US lasts, it...

In South Africa, a strong trade surplus, buoyed by robust commodity prices, will cushion our economy against pressure arising from US policy

Farmers squeezed by big retailers

It may be beneficial for consumers when supermarkets push to get the lowest price from suppliers, but it can harm the farmers

Covid-19: No vaccine booster shots needed yet

Scientists agree it is important to get most of the population vaccinated before giving booster jabs

press releases

Loading latest Press Releases…