Children and Tuberculosis: A Neglected Demographic

Today is National Tuberculosis Day, and our guest bloggers provide critical information about this disease that is a leading cause of death in children.

by Neda Dowlatshahi and Rachel Hampton, research associates, Global Health Council

Of about 9 million cases of TB that occur annually, about 1 million occur in children under age 15. In some developing countries, children account for up to 25 percent of cases. TB causes more than 40,000 deaths among children under age 5 each year. Typically, TB progresses more rapidly and is more severe in younger children; it also contributes to the high burden of childhood pneumonia.

TB is aptly described as “a disease of poverty,” as it infects millions of children in poor living conditions. Malnutrition, food insecurity, HIV infection, overcrowding, and a less-developed immune system are among the factors that put children at risk and may also increase the rate of disease progression.

TB is often transmitted to children by their mothers, as TB is the third leading cause of death of women age 15-44. Although providing treatment to family members may avert thousands of pediatric infections, studies have shown that even if you increase treatment of adult TB, many children would continue to die from the disease. Nonetheless, integrating pediatric TB services into broader maternal and child health intervention packages would be an efficient way to ensure that children received the care they need.

In terms of prevention and treatment for children, the BCG vaccine should be given soon after birth, as it can help to prevent TB meningitis. A new, cost-effective TB vaccine could reduce childhood TB infections. Caregiver education is also critical to ensure proper prevention and treatment.

Not only are children at risk of infection, but they are at risk of becoming orphans – in India alone, 300,000 children are orphaned every year due to TB. In many developing countries, orphans face increased stigmatization and discrimination in society, which may hinder their access to services and future educational and employment opportunities.

When family members are infected, children are often obliged to work to provide food and income. This forces children out of school, affecting their education and future employment opportunities.

So, why aren’t we paying more attention to pediatric TB? Some speculate that more attention is placed on prevention and treatment for adults since children are rarely contagious. Another reason is that the diagnostics and research studies are limited. Whatever the reasons, we need to do a better job in preventing and treating pediatric TB.

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