A large gap exists between the number of TB cases in children that are reported and the number of children who are actually infected, researchers report.
A new study, published in the journal Lancet Global Health, suggests that in the 22 countries with the highest TB burden, more than 650,000 children developed the disease in 2010, while 7.6 million became infected with the TB bacterium. But overall, more than 53 million children were estimated to latently harbor the infection.
DIFFICULT TO DIAGNOSE
Diagnosing TB in children can be challenging and the disease can often be overlooked or mistaken for something else. This can lead to under-reporting, distorting the true scope of the problem and the real demand for pediatric TB treatment.
The first estimates of pediatric TB by the World Health Organization (WHO) were published in 2012, and last year the WHO estimated 530,000 pediatric cases worldwide. However, given the acknowledged difficulties in detecting TB in children, experts say there is need for additional study and focus on the burden of disease in children.
“Quantifying the burden of TB in children is important because without good numbers, there can be no targets for improvement, no monitoring of trends, and there is a lack of evidence to encourage industry to invest in developing medicines or diagnostics that are more appropriate for children than those available today,” says Peter Dodd, a researcher from the University of Sheffield’s School of Health and Related Research.
“Historically, TB in children has not received the attention that it might have done,” he adds. “The WHO is now encouraging countries to report the number of TB cases they find in children, but we still have only a poor idea what proportion of cases are recorded in youngsters.”
In addition to providing global estimates, the study also revealed additional findings. More than a quarter of all pediatric TB cases were found in India and 15 million children under the age of 15 were found to be living with somebody with TB. The 53 million children with latent TB represent a huge reservoir for future disease.
“Although these 53 million infected children may not be currently experiencing any problems, they are at a very high risk for developing the disease in the future,” says study coauthor James Seddon from the medicine department at Imperial College London. “It is also interesting to note that only a third of children with TB disease are currently identified, treated, and reported. This compares to two thirds in adults.”
UNITAID and USAYS supported the research.
《Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study》, Published on Journal 《The Lancet》in Aug 2014.