CNS: Children and TB: A Hidden Epidemic

Tuberculosis (TB) among children is rarely discussed. Because children, more often than not cannot speak for themselves, not much about how they're affected by the disease ever hits the headlines. This is despite the fact that TB remains among the top ten killers of children worldwide. In spite of this, virtually no public or political attention is paid to TB as a children’s health issue. The World Health Organization (WHO) estimates that approximately 176,000 children died, but the consensus among researchers says that actual figures are higher. In 2009 alone, at least 1 million children became sick with TB.

A report titled "Children and Tuberculosis: Exposing A Hidden Epidemic," states that TB preys on the most vulnerable children - the orphaned, the malnourished, those living with HIV - and it causes an almost unimaginable burden to children and their families.

According to Dr. Jeffrey Starke, a leading TB specialist at Texas Children’s Hospital, childhood TB “is a fundamentally different disease from adult tuberculosis. Its proper diagnosis, treatment, and prevention require specific planning and resources. We must consider the unique nature of childhood

TB if we’re to successfully eliminate TB anywhere in the world.”

"Approximately 9 million people become sick with TB each year.2 At least 10-15 percent of these cases are in children under 15 — but the percentage is probably much higher, because childhood TB is under-reported," states the report.

Most children have a type of TB classified as sputum smear-negative TB which makes them less likely to spread the disease to others — but it’s still deadly if left untreated. Because on average children are less contagious than adults, they’ve been overlooked by national TB programs.

"While adults most often get TB in their lungs, in children the disease often spreads to other parts of the body. Children are therefore more likely than adults to develop severe forms of TB, including TB meningitis. TB meningitis occurs when the bacteria spread to the central nervous system, including the brain. The bacteria inflame the tissue that protects the brain, causing it to swell. TB meningitis is most common in children under two years old, and the disease is almost always fatal without treatment. TB can attack virtually any part of a child’s body in similar fashion," states the report.

It is more cost effective to prevent disease than it is to treat it. The most effective way to prevent childhood TB is to stop the disease from spreading in the wider community.

“Even with the limited tools currently available, better organization of services and aggressively identifying recently exposed and infected children would prevent tens of thousands of tuberculosis cases in children every year,” said Dr. Starke.

Chief K.Masimba Biriwasha - CNS

(The author, born in Zimbabwe, is a children's writer, poet, playwright, journalist, social activist and publisher. He has extensively written on health. His first published book, 'The Dream Of Stones', was awarded the Zimbabwe National Award for Outstanding Children's Book for 2004)