Status of implementation of recommendations for section Childhood TB
| Recommendations | Status | Implementation | Institution responsible for implementation | Deadlines |
| Childhood TB | ||||
| General recommendations | ||||
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1. The national guidelines on management of TB in children should be revised according to the international standards. |
Implemented
|
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2. Inpatient treatment should be limited to complicated and drug-resistant cases of TB. |
Not implemented
|
Inpatient treatment is also prescribed in other cases. The protocol does not specify that only severe TB and MDR-TB are subject to the hospitalization. |
UCDC
|
31.12.14
|
| Special recommendations | ||||
|
3. BCG should be limited to one vaccination at birth. |
Not implemented
|
As provided with the applicable Order of the Ministry of Health of Ukraine dated 16.09.2011 No. 595 “On Procedure of Prophylactic Immunization in Ukraine and Quality and Circulation Control of Medicinal Immunobiological Products”, BCG revaccination is made at the age of 7. Pursuant to the information of Ukrainian Centre for Socially Dangerous Diseases Control, the draft Order of the Ministry of Health of Ukraine dated 21.12.2012 No. 1091 was amended as recommended by WHO. |
UCDC
|
31.12.14
|
|
4. The national policy on annual skin testing screening should be revised. Such testing should be limited to risk groups of children. |
Not implemented
|
In accordance with the unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis”, the annual screening with skin tuberculine test is performed on an annual basis to all children aged 4-14 (first of all, children from TB risk groups). Pursuant to the information of Ukrainian Centre for Socially Dangerous Diseases Control, the draft Order of the Ministry of Health of Ukraine dated 21.12.2012 No. 1091 was amended as recommended by WHO. |
UCDC
|
31.12.14
|
|
5. Dosage of basic anti-TB drugs should be revised in line with WHO recommendations. Ethambutol should be used rather than streptomycin in the first-line regimen. |
Implemented
|
Dosing of major anti-tuberculosis drugs was revised and Ethambutol was provided as a first-line therapy instead of Streptomycin, which is reflected in the unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” (page 151). |
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6. Isoniazid preventive chemotherapy schemes should be prolonged to six-month regimens and provided under ambulatory conditions. |
Partially
|
The unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” (page 140) stipulates that regimens for chemoprophylaxis (basic) in children must be designed for 3-6 months. |
UCDC
|
31.12.14
|
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7. Inpatient treatment should be limited and inpatient preventive chemotherapy in sanatoria should be stopped. |
Implemented
|
Preventive chemotherapy is restricted under in-patient conditions, in accordance with the unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” (article 141). It may be received under conditions of a health resort, in general secondary and specialized schools for children under control exercised by a doctor or a nurse; or under out-patient conditions under control of a paediatric phthisiatrician, if certain guarantees of continuity and completion of prescribed chemoprophylaxis are available. |
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National recommendations were revised in the unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” and comply with the International Standards (page 151).