Minister of Health Mam Bun Heng has instructed health officials at provincial and district hospitals, as well as health centres, to diagnose tuberculosis (TB) as early as possible, particularly in malnourished children, children living with HIV and AIDS, and children with severe pneumonia.

Bun Heng said last week that officials at the provincial and district levels, and at health centres, must work directly with local communities to discover which families had cases of TB for speedy diagnosis and treatment, with TB an infectious disease that could be cured.

“If TB is found in a child, it is not only necessary to check the child, but also whether the parents or guardians have TB. Otherwise, treatment will not be complete,” he said.

He also instructed officials at the National Centre for Tuberculosis and Leprosy Control (CENAT) to carry out frequent visits at the sub-national level to spread awareness about tuberculosis.

The minister stressed that it was not only necessary to provide TB awareness theory, but its implementation was also needed to ensure the eradication of TB in Cambodia by 2030.

Combating childhood TB is one of the World Health Organisation’s “End TB” strategies, and a core priority of Cambodia’s National Strategic Plan to End Tuberculosis 2021-2030, the UN health agency says.

Pol Sokha, the head of the paediatric unit at Takeo provincial hospital, said the implementation of the TB-Speed project required hospitals to conduct additional TB research on children with certain diseases.

For example, children with pneumonia can not only be diagnosed with pneumonia, but can also be found to have tuberculosis, he said.

“According to the results of our research at the Takeo provincial hospital, we found around 150 children with tuberculosis,” Sokha said.

Huot Chan Yuda, director of CENAT, said the purpose of the TB-Speed research project was to reduce child mortality by improving the diagnosis of TB through innovative and effective approaches.

In particular, he said, the decentralisation of TB diagnosis aimed to bring diagnostic services closer to the people, while diagnosing TB among the most vulnerable children, such as those with severe pneumonia, disabilities or malnutrition, or those living with HIV.

The TB research project on children with pneumonia is being conducted at the National Paediatric Hospital, and the Kampong Cham and Takeo provincial hospitals, he added.

The TB-Speed Project has been implemented in Cambodia since 2017.

Chan Yuda said that in the first six months of this year, the provisional results of the TB-Speed team found 11,881 cases of TB, including 2,914 cases in children, and 52 cases of drug-resistant TB.

However, he said while there were more than one million new cases of TB across the world in 2020, only 400,000 had been reported.

More than half the children and adolescents with TB faced barriers to accessing care due to the difficulty of diagnosis and treatment, he added.

French Ambassador Jacques Pellet said his embassy is highly committed to the health sector in Cambodia, with support through scholarship programmes in medical studies or funding from international experts to support key health organisations, for example.

And the Institut Pasteur du Cambodge (IPC) has on numerous occasions been thanked for its contributions to the management of Covid-19.

Research clinics are a key component of the research activities conducted by the IPC and have made significant contributions to addressing key public health priorities and research gaps in Cambodia.

“The strong relationship between the IPC and the Ministry of Health, with excellent research, can be used to review international and national guidelines that contribute to improving prevention, diagnosis and the care of patients,” Pellet said.

Professor Andre Spiegel, director of IPC, said that the diagnosis of TB was complicated in children, especially due to the small amount of virus in the sputum and the complexity of collecting samples, especially in the very young.

The [TB-Speed] project is being implemented in seven countries in Southeast Asia, including Cambodia, all of which have limited resources, he said.

The development and implementation of this type of clinical research project is particularly relevant for the IPC by taking into account research gaps and public health priorities in Cambodia.