Factsheets

Children and TB

The Nature and magnitude of TB among children

  • TB is one of the top ten killers of children worldwide. Each year half a million children develop TB and 70,000 die as a result.[1]
  • In 2010, some 10 million children were orphaned as a result of TB.[2]
  • In developing countries children make up 20-40% of all TB cases, disproportionately affecting children who are orphaned, malnourished, and HIV positive.
  • U to 50% of children living in a household where an adult has active TB, become infected with TB.[3]
  • Children have less developed immune systems and are more susceptible to contracting more severe forms of TB, such as TB meningitis, that are often fatal.
  • Because they are less likely to be infectious, children are given low priority within national health programs. Few resources are put towards preventing, diagnosing, and treating TB in children.
  • Of the 9 million TB cases worldwide each year, 10-15% are in children.
  • Malnutrition and TB have similar symptoms: failure to gain weight, loss of energy, and a persistent cough. These similarities can easily lead to misdiagnosis.

Difficulties diagnosing and treating TB in children

  • There is no definitive ‘gold standard’ for diagnosing TB in children. Although there have been recent advancements in TB diagnostics, these have not been approved for use in children.
  • Children are repeatedly excluded from clinical trials and almost no child-friendly TB drugs exist.
  • Drugs to treat MDR-TB are very toxic to young children and cause deafness, vomiting, and thyroid problems.
  • Although many children are given a vaccine to protect against TB, immunity from the vaccine wears off with age and causes adverse effects in children with HIV.
  • Children are often taken to children’s health clinic or general clinic instead of TB clinic because their symptoms are generally different than a chronic cough; then they are undiagnosed or misdiagnosed.
  • TB treatment in HIV positive and uninfected children are the same, but certain types of antiretroviral drugs interact with TB medications in children and can cause a decrease in efficacy of both drug regimens and/or toxic side effects.

Recommendations

  • Fighting childhood TB must become a global health priority. New resources are needed to eliminate TB as a top killer of children.
  • TB services should be integrated with child health programs, including HIV services.
  • Children need to be involved in clinical trials for TB so that child-friendly drugs and diagnostics can be developed.
  • All children who have been in contact with an adult who has TB should be given Isoniazid preventive therapy (IPT), which is effective at preventing the disease from becoming active.
  • Early diagnosis and successful treatment of infectious adults that live with children are key to protecting children
  • All children diagnosed with TB should be tested for HIV.

For more information check out ACTION’s report Children and Tuberculosis: Exposing a Hidden Epidemic.

 

[1] Stop TB Partnership. (2012). Combating tuberculosis in children [fact sheet]. Geneva: Stop TB Partnership.

[2] Combating tuberculosis in children, 2012.

[3] TB Alert. (2011). TB and Children [fact sheet]. London: TB Alert.