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.
- In 2010, some 10 million children were orphaned as a result of TB.
- 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.
- 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.
- 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.