H. Simon Schaaf
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View article: Multi-view deep learning framework for the detection of chest X-rays compatible with pediatric pulmonary tuberculosis
Multi-view deep learning framework for the detection of chest X-rays compatible with pediatric pulmonary tuberculosis Open
Tuberculosis (TB) remains a major global health burden, particularly in low-resource, high-prevalence regions. Pediatric TB diagnosis poses challenges with non-specific symptoms and less distinct radiological manifestations than adult TB. …
View article: Global child-friendly anti-TB medicines – where do we stand?
Global child-friendly anti-TB medicines – where do we stand? Open
An increasing number of children are diagnosed and started on antituberculosis treatment. Despite progress in developing child-friendly antituberculosis formulations for drug-susceptible and drug-resistant TB, a single-medicine rifampicin …
View article: Lung function trajectories in children with pulmonary TB and non-TB lower respiratory tract infections
Lung function trajectories in children with pulmonary TB and non-TB lower respiratory tract infections Open
BACKGROUNDThis longitudinal study compared lung function in children with pulmonary TB (PTB), children with non-TB lower respiratory tract infections (LRTIs) and healthy controls.METHODSChildren aged 4–13 years presenting with presumed PTB…
View article: Factors Predictive of Early Discontinuation of Preventive Treatment in Children With Household Exposure to Multidrug-resistant Tuberculosis
Factors Predictive of Early Discontinuation of Preventive Treatment in Children With Household Exposure to Multidrug-resistant Tuberculosis Open
Background The World Health Organization recommended levofloxacin for tuberculosis (TB) preventive treatment for child and adult contacts of multidrug-resistant TB. Method TB-CHAMP (ISRCTN92634082) was a double-blind community-based multis…
View article: Health-service costs for the treatment of multidrug-resistant/rifampicin-resistant tuberculosis in children in South Africa: application of a real-world dataset
Health-service costs for the treatment of multidrug-resistant/rifampicin-resistant tuberculosis in children in South Africa: application of a real-world dataset Open
Background Children with multidrug-resistant (MDR) / rifampicin-resistant (RR)-tuberculosis (TB) are an important but neglected group in cost-effectiveness research. Digital health information systems enable new approaches to health-servic…
View article: Risk of Tuberculosis Infection in Young Children Exposed to Multidrug-resistant Tuberculosis in the TB-CHAMP Multi-site Randomized Controlled Trial
Risk of Tuberculosis Infection in Young Children Exposed to Multidrug-resistant Tuberculosis in the TB-CHAMP Multi-site Randomized Controlled Trial Open
Background Young children have a high risk of developing tuberculosis (TB) disease following infection with Mycobacterium tuberculosis in the absence of preventive treatment. Infection prevalence and risk factors for infection impact deliv…
View article: Experiences of children and their caregivers affected by multidrug-resistant tuberculosis in Cape Town, South Africa
Experiences of children and their caregivers affected by multidrug-resistant tuberculosis in Cape Town, South Africa Open
Background Approximately 30,000 children (<15 years) develop multidrug-resistant (MDR) tuberculosis (TB) each year. MDR-TB severely impacts the lives of children and their families, yet data exploring their experiences are limited. We desc…
View article: Incidence, Disease Spectrum, and Outcomes of Tuberculous Meningitis in South African Children: The Initial Impact of COVID-19
Incidence, Disease Spectrum, and Outcomes of Tuberculous Meningitis in South African Children: The Initial Impact of COVID-19 Open
Tuberculous meningitis (TBM) is a very severe form of childhood tuberculosis (TB), requiring hospitalisation for diagnosis. We investigated trends in admission, disease spectrum, outcomes, and healthcare system factors in children with TBM…
View article: BEAT Tuberculosis: a randomized controlled trial of a 6-month strategy for rifampicin-resistant tuberculosis
BEAT Tuberculosis: a randomized controlled trial of a 6-month strategy for rifampicin-resistant tuberculosis Open
Background Safer, more effective treatment regimens for rifampicin-resistant tuberculosis are needed. We evaluated a novel six-month RR-TB treatment strategy. Methods We conducted a phase III, open-label, multi-centre, pragmatic, noninferi…
View article: Epidemiological insights into paediatric tuberculosis trends in the Western Cape, South Africa
Epidemiological insights into paediatric tuberculosis trends in the Western Cape, South Africa Open
Paediatric tuberculosis (TB) remains a major public health concern in high-burden settings like the Western Cape (WC), South Africa. We analysed geographic differences in TB burden among children and adolescents, described temporal trends,…
View article: Oral Swab Testing With Xpert MTB/RIF Ultra for the Diagnosis of Tuberculosis in Children Aged &lt;5 Years in Uganda: An Exploratory Interim Analysis of Diagnostic Accuracy in the NOD-pedFEND Cohort
Oral Swab Testing With Xpert MTB/RIF Ultra for the Diagnosis of Tuberculosis in Children Aged <5 Years in Uganda: An Exploratory Interim Analysis of Diagnostic Accuracy in the NOD-pedFEND Cohort Open
Background Obtaining respiratory samples to diagnose tuberculosis in young children is challenging. Oral swabs are alternative noninvasive specimens for microbiology. Methods We conducted an interim prospective diagnostic accuracy evaluati…
View article: Acceptability of a 250 mg levofloxacin formulation in children receiving TB preventive treatment
Acceptability of a 250 mg levofloxacin formulation in children receiving TB preventive treatment Open
BACKGROUNDRecent evidence indicates that levofloxacin (LFX) is effective in preventing TB in individuals exposed to multidrug-resistant TB (MDR-TB). Despite the need for pediatric formulations, the 250 mg adult LFX formulation is affordabl…
View article: Pharmacokinetics and Safety of Clofazimine in Children With Rifampicin-Resistant Tuberculosis
Pharmacokinetics and Safety of Clofazimine in Children With Rifampicin-Resistant Tuberculosis Open
Background We described the pharmacokinetics and safety of clofazimine in children treated for multidrug/rifampicin-resistant tuberculosis (MDR/RR-TB). Methods Children aged <18 years were eligible. Clofazimine was administered by weigh…
View article: Blood-based diagnosis of pediatric tuberculosis: A prospective cohort study in South Africa and Dominican Republic
Blood-based diagnosis of pediatric tuberculosis: A prospective cohort study in South Africa and Dominican Republic Open
Serum MAP-TB results can effectively diagnose pediatric TB, including unconfirmed and extrapulmonary TB missed by current methods, and correspond to effective treatment.
View article: A historical narrative review of the emerging priority of acceptability in tuberculosis treatment in children
A historical narrative review of the emerging priority of acceptability in tuberculosis treatment in children Open
Children affected by tuberculosis (TB) are a historically neglected group. In the past two decades, researchers have made significant advances towards developing new drugs and formulations for treating and preventing TB in children. Organi…
View article: A Meta-Analysis of Levofloxacin for Contacts of Multidrug-Resistant Tuberculosis
A Meta-Analysis of Levofloxacin for Contacts of Multidrug-Resistant Tuberculosis Open
In this meta-analysis of two randomized trials, levofloxacin was associated with a 60% relative reduction in TB incidence among adult and child household MDR-TB contacts, but with an increased risk of musculoskeletal adverse events. (Funde…
View article: Approaches and processes for paediatric chest X-ray classification used in the SHINE TB treatment-shortening trial
Approaches and processes for paediatric chest X-ray classification used in the SHINE TB treatment-shortening trial Open
INTRODUCTIONSHINE (Shorter Treatment for Minimal Tuberculosis in Children) was the first Phase 3 paediatric TB treatment-shortening trial. Robust chest X-ray (CXR) classification methods were integral to excluding severe disease for trial …
View article: Linezolid Pharmacokinetic-Anemia Modeling in Children With Rifampicin-Resistant Tuberculosis
Linezolid Pharmacokinetic-Anemia Modeling in Children With Rifampicin-Resistant Tuberculosis Open
Background Linezolid, a component of rifampicin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB) treatment, is associated with treatment-limiting toxicities, including anemia. Patient-level and linezolid pharmacokinetic risk factors …
View article: Navigating complex care pathways–healthcare workers’ perspectives on health system barriers for children with tuberculous meningitis in Cape Town, South Africa
Navigating complex care pathways–healthcare workers’ perspectives on health system barriers for children with tuberculous meningitis in Cape Town, South Africa Open
Tuberculous meningitis (TBM) occurs when tuberculosis (TB) bacilli disseminate and seed into the meninges, triggering a severe inflammatory response that often leads to brain infarction. It is the most severe and debilitating form of child…
View article: Holistic acceptability of an adult levofloxacin formulation in children and adolescents on a tuberculosis preventive treatment trial
Holistic acceptability of an adult levofloxacin formulation in children and adolescents on a tuberculosis preventive treatment trial Open
Drug-resistant tuberculosis (TB) is threatening global TB control. Although formulations designed for children are a priority, adult levofloxacin formulations are widely used in TB treatment and prevention. TB-CHAMP was a cluster-randomise…
View article: Severe BCG immune reconstitution inflammatory syndrome lymphadenitis successfully managed with pre-antiretroviral counseling and a non-surgical approach: a case report
Severe BCG immune reconstitution inflammatory syndrome lymphadenitis successfully managed with pre-antiretroviral counseling and a non-surgical approach: a case report Open
Background Bacillus Calmette-Guérin (BCG) reactions are the most common cause of immune reconstitution inflammatory syndrome (IRIS) in HIV-positive infants who initiate antiretroviral therapy (ART). There is limited evidence regarding the …
View article: Chest X-Ray–Based Telemedicine Platform for Pediatric Tuberculosis Diagnosis in Low-Resource Settings: Development and Validation Study
Chest X-Ray–Based Telemedicine Platform for Pediatric Tuberculosis Diagnosis in Low-Resource Settings: Development and Validation Study Open
Background Tuberculosis (TB) remains a major cause of morbidity and death worldwide, with a significant impact on children, especially those under the age of 5 years. The complex diagnosis of pediatric TB, compounded by limited access to m…
View article: Clinical Outcomes in Children With Human Immunodeficiency Virus Treated for Nonsevere Tuberculosis in the SHINE Trial
Clinical Outcomes in Children With Human Immunodeficiency Virus Treated for Nonsevere Tuberculosis in the SHINE Trial Open
Background Children with human immunodeficiency virus (HIV, CWH) are at high risk of tuberculosis (TB) and face poor outcomes, despite antiretroviral therapy (ART). We evaluated outcomes in CWH and children not living with HIV treated for …
View article: Pharmacokinetics and Optimal Dosing of Levofloxacin in Children for Drug-Resistant Tuberculosis: An Individual Patient Data Meta-Analysis
Pharmacokinetics and Optimal Dosing of Levofloxacin in Children for Drug-Resistant Tuberculosis: An Individual Patient Data Meta-Analysis Open
Background Each year 25 000–32 000 children develop rifampicin- or multidrug-resistant tuberculosis (RR/MDR-TB), and many more require preventive treatment. Levofloxacin is a key component of RR/MDR-TB treatment and prevention, but the exi…
View article: Impaired lung function in adolescents with pulmonary tuberculosis during treatment and following treatment completion
Impaired lung function in adolescents with pulmonary tuberculosis during treatment and following treatment completion Open
EDCTP, National Institute of Health, Medical Research Council, BMBF.
View article: Pharmacokinetics and cardiac safety of clofazimine in children with rifampicin-resistant tuberculosis
Pharmacokinetics and cardiac safety of clofazimine in children with rifampicin-resistant tuberculosis Open
Clofazimine is recommended for the treatment of rifampicin-resistant tuberculosis (RR-TB), but there is currently no verified dosing guideline for its use in children. There is only limited safety and no pharmacokinetic (PK) data available…
View article: Current Treatment of Drug-Resistant Tuberculosis in Children
Current Treatment of Drug-Resistant Tuberculosis in Children Open
Optimal diagnosis and management of children aged <15 y with rifampicin- or multidrug-resistant tuberculosis (RR/MDR-TB) relies on identification of adults with the disease and pro-active screening of their close contacts. Children may be …
View article: Optimizing dosing of the cycloserine pro-drug terizidone in children with rifampicin-resistant tuberculosis
Optimizing dosing of the cycloserine pro-drug terizidone in children with rifampicin-resistant tuberculosis Open
There are no pharmacokinetic data in children on terizidone, a pro-drug of cycloserine and a World Health Organization (WHO)-recommended group B drug for rifampicin-resistant tuberculosis (RR-TB) treatment. We collected pharmacokinetic dat…