You are here:

World TB Day Lancet Viewpoint: child survival linked to TB control

Published on

Updated:

Tuberculosis has a hidden impact on child survival, both directly and indirectly, according to a Viewpoint article published in the Lancet on World TB Day (24 March). Written by The Union’s Steve Graham, Anne Detjen and others, the article illustrates how the full impact of child TB is vastly underestimated due to policies regarding TB case finding and recording, inadequate diagnostic tests for children, lack of awareness among community health professionals who serve children and criteria for gathering vital registration data that attribute TB-related deaths to HIV, pneumonia, malnutrition and other causes. 

In “Importance of tuberculosis control to address child survival”, Graham et al. make the case for providing greater attention to child TB if goals for child survival, such as MDGs 4 and 5 (child and maternal mortality) and MDG 1 (undernutrition) are to be met.  

Time and again, TB’s impact is missed or hidden, which has contributed to its low priority until recently. For example, one study indicates that as many as 10% of the 1 to 3 million children estimated to have died of pneumonia actually died of TB. This alone would more than double the World Health Organization’s present estimate of 74,000 deaths per year.

Another telling example looks at the survival of TB orphans – estimated in 2011 by WHO at 9.7 million children globally. In limited-resource settings, the death of a parent is a major predictor of child mortality; and a study in Guinea-Bissau found that children whose mother had TB had an 8-times greater risk of mortality than those who lived in a TB-free home.

The authors, most of whom served on the core writing team for the Roadmap for Childhood TB: Towards Zero Deaths, reference that document’s goal to improve this situation by bringing maternal and child health services and both TB and HIV services together to provide integrated care and effective monitoring for childhood TB.

The article closes with a quote from pioneering paediatrician Edith Lincoln: “Wherever there are tuberculous adults there are infected children. No one is immune. No child will be even relatively safe from tuberculous infection and some of its dread sequelae until tuberculosis is diminished to the point where it is no longer a public health problem.”

Read the full article in the Lancet