Thank you Aung Aung for your presentation - Can you clarify how many of the children experiencing visual hallucinations or night terrors were receiving both delamanid and cycloserine/terizodone? Any attempts to reintroduce DLM and not Cs or vice versa?

Thank you so much Dr. Aung - great presentation. Can you clarify what TB diagnostic testing and drug sensitivity testing was done on the cohort of children? I think you mentioned X-ray, clinical evaluation and smear - I was wondering about additional tests. Thank you.

no sound

Can you recall what PICC stands for ?

peripherally inserted central catheter

Peripherally Inserted Central Catheter

with the new WHO rapid communication on DR-TB treatment, should we now explore the use of these 6 month regimens in children? I think children should also benefit from better and shorter DR-TB regimens.

Regarding the question on hallucinations in children - all cases we observed ww were exposed to Dlm, 65% were also exposed to Cs/Trd. Dlm dechallenge was positive in all but 1 case (AE disappeared when Dlm was stopped); Dlm rechallenge was positive in 6 cases (AE reappeared when Dlm resumed); Cs/Trd was additionally suspected and permanently withdrawn when not tolerated. The hallucinations caused by Dlm were fully reversible.

Thanks Nathalie for the first question. For the diagnostic testing for children - apart from clinical evaluation and X-rays, we do TST, sputum - induction for child who cannot produce, and culture and DST. We also did an operational research on stool detection of MTB with GeneXpert Ultra which we are doing analysis of the result.

9 month regimen for MDR looks good but regimen for FQ R and BDQ resistant with E Z seems weak as most such cases would already be resistant to E Z . can imipenem/meropenem be included?

Thanks, everyone. Tony, the Bdq dosing is 3xweek (after loading) in children, as in adults, right? If so, has there been any empirical work (or simulations, as for adults) about a daily dosing option for children?

And, Aung, following up on Charlotte's question: can you also remind us of the screening part of the algorithm (i.e., was xray performed in all contacts or only those with symptoms)? How did you manage the expertise required to read xrays in kids?

Thank you Dr. Aung, and looking forward to hearing more about the OR on stool diagnosis when you have results to share.

per Tony's comment about the limited comparative data between pretomanid and delamanid. This has been recently summarized: Delamanid or pretomanid? A Solomonic judgement!J Antimicrob Chemother. 2022 Mar 31;77(4):880-902. doi: 10.1093/jac/dkab505.

TST in Tajikstan presentation was performed for what purpose ? Thanks .

We saw few nocturnal terrors in Mumbai but all improved after stoping Cs, we did not need to stop Dlm

Anecdotally, also taking Dlm with meals seems to help

Many thanks to all the presenters - this was a great webinar.

Very informative indeed. Thank you

@Nathalie - that is an interesting anecdote about taking with meal as food increases absorption of DLM two-fold (fatty foods even more) so one would posit that psych AEs might be increased with higher blood levels.Thank you presenters! Excellent work

in India now its suggested to do IGRA and BaselineXRay for asymptomatic contacts, AI options are also being explored

thanks a lot to all for this wonderful session

excellent presentations and full webinar. thanks, everyone!

Thank you for very informative session!

excellent presentations, thanks a lot, everyone!

thanks dr.aung aung, dr,vijay, dr.cathy. Robert:-)

Thank you everyone! Wonderful webinar!

thanks

Thank you for the very interesting presentations

Thank you for the webinar

Thanks