Updated 02 October 2013

Half a million kids get TB every year

According to the WHO more than 200 children under the age of 15 die from tuberculosis every day, even though it's a preventable disease.

The World Health Organisation, the International Union against tuberculosis and Lung Disease and the Stop TB partnership have launched a plan which specifically addresses TB in children and outlines a path towards zero deaths from childhood TB.

The interim executive director of the union, José Luis Castro, said: "If we can shift TB diagnosis and treatment out of specialised programmes and into other existing maternal and child health activities, we automatically gain reach and scale."

"Combining that scale with investment in tools and medicine would save tens of thousands of lives."

More than half a million children become ill with TB every year with 70%-80% of them having pulmonary TB, and the rest are affected by the disease in other parts of the body (extra-pulmonary TB).

Preventable and curable disease

Every day over 200 children under the age of 15 die worldwide from this preventable and curable disease, bringing the annual death toll to 74 000 in case of HIV-uninfected children.

Referring to India, a revised national TB control programme estimated that the number of paediatric TB cases had shown an increasing trend in the past five years and about 81 400 cases were reported in 2012. However, the programme said, the number of childhood TB (globally as well as in India), could be much higher because TB in children often went undiagnosed.

The new initiative estimates that these lives could be saved by spending about $120m a year, which includes $40m for antiretroviral therapy and preventive therapy for children co-infected with TB and HIV. It says this is a small price tag for a global disease and is needed to improve detection, develop better medicines for children and integrate TB treatment into existing maternal and child health programmes.

The initiative says the director of the global tuberculosis programme at WHO, Dr Mario Raviglione, was quoted as saying "any child who dies from TB is one child too many."

“We know TB is preventable and treatable; this roadmap shifts our focus from the challenges we face to immediate actions we can take."

Diagnosis and treatment

The programme listed ten action points at international and national levels to tackle childhood TB:

*   Include the needs of children and adolescents in research, policy development and clinical practices;
*   Collect and report better data, including data on prevention;
*   Develop training and reference materials for health care workers;
*   Foster local expertise and leadership;
*   Use critical intervention strategies (like intensive case finding, contact tracing, preventive therapy, early diagnosis and uninterrupted supply of standard anti-TB medicines for children);
*   Engage key stakeholders;
*   Develop integrated family-centred and community-centred strategies;
*   Address research gaps and develop new diagnostics, medicines and vaccines;
*   Meet funding needs for childhood TB and
*   Form coalitions and partnerships to improve tools for diagnosis and treatment.

The director of the Centre for Global Health at the US Centres for Disease Control and Prevention, Dr Tom Kenyon, said: "We must ensure that systems are in place to serve children through existing health, community and centres involving children."

Other decisions

Short term by 2015:  Increased action to implement contact investigation and how to manage TB in children and advocacy for research on new diagnostics, drugs and vaccines for childhood TB.

Medium term by 2020:  Improved prevention, detection, diagnosis and management of TB in children and pregnant women and the development of new diagnostics suitable for children.

Long term by 2050:  Test for latent TB with ability to predict disease progression in children and vaccines to prevent infection and disease in children and adults.

Colleen Daniels, the director TB/HIV of the Treatment Action Group said: "Current diagnostics, toxic drugs and inadequate drug formulations are insufficient to respond to the needs of children with TB."

"New tools will be a crucial part of addressing TB in children and current investments are minimal at best. Much more investment and commitment to childhood TB is urgently needed now."

Photo of TB test tube from Shutterstock


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