Silent Epidemic: a call to action against child tuberculosis

These images show part of an exhibition telling the stories of children and families in Benin and Uganda, where Union projects are trying to find new ways to beat childhood TB.

On World Chidren’s Day the following images show part of an exhibition displayed recently in the City Hall of The Hague, the Netherlands, as  a call to action against child tuberculosis’ was displayed. The exhibition told the stories of the children and their families in Benin and Uganda, where Union projects are trying to find new ways to beat childhood TB.

An estimated one million children under the age of 15 become sick with tuberculosis (TB) each year. Of those, 239,000 – nearly one in four – die. Yet TB is a treatable and curable disease and children who receive standard treatment for the disease rarely die.

Ninety percent of children who die from TB worldwide went untreated. This widespread neglect means the loss of a million children every four years, creating trauma for the families they leave behind.

Child TB is a silent epidemic – one that impacts children too young to stand up for themselves. The Union is a global leader in the fight to end TB. We use science to design the best treatments and policies for patients and the health workers who serve them.

In Benin, The Union’s TITI Study enrolled 2000 children over an 18-month period. The study identified children at increased risk of TB and placed them on treatment. Children under five years of age, who shared a home with an adult who had been diagnosed with TB, were checked for symptoms during home visits.

Ninety percent of the children enrolled were started on preventative therapy and five percent were diagnosed with active TB and placed on treatment.

In Uganda, DETECT Child TB works with partners to empower frontline health workers to provide TB screening meaning diagnosis happens in village health centres, rather than central hospitals, catching the disease earlier and lessening burden on hospitals.

Photographers Will Boase and Javier Galeano met with families in their homes and while attending clinics with community workers, healthcare teams and Union staff. Thanks go to all the people who shared their stories and allowed us to take their photographs.

ansek
Image credit Will Boase. 

Ansek, two and a half, was photographed during a consultation with the nurse to initiate preventive treatment. Ansek’s uncle is in treatment for TB. Initiation into The Union’s TITI study requires children to visit the clinic twice in the beginning – once to have a TB skin test and chest X-ray, and again so the health staff can analyse the results of the test and begin TB treatment or preventive therapy.

belvine
Image credit Will Boase. 

Two year old Belvine sits with her mother as they wait to visit the nurse at her monthly checkup into her preventive TB treatment, as part of The Union’s TITI study.

Carlos-and-Djahou

Image credit Will Boase. 

Brothers Carlos and Djahou, both three years old, visit the nurse at a Benin TB clinic during a monthly checkup. They are on preventive treatment and are doing well. Their older brother is also receiving treatment through The Union’s TITI study. 

Emmanuella

Image credit Will Boase. 

Emmanuella with her mother, Edith, while waiting for her monthly checkup with the nurse at the TB clinic as part of The Union’s TITI study. Emmanuella’s aunt was diagnosed with TB after several long weeks of tests with inconclusive results. Edith brought her to this TB clinic where she is now receiving treatment. Emmanuella has been on preventive treatment for several months and is doing well.

esther

Image credit Will Boase. 

Esther was born with HIV and tested positive for TB while pregnant with her son, who is now four months old. Through The Union’s DETECT Child TB project, Esther began TB treatment just after giving birth and her son was placed on preventive therapy. 

francois

Image credit Javier Galeano 

Four year old Françoise was treated and cured of TB through The Union’s DETECT Child TB project following six months of treatment. She was photographed with her mother in her home in Entebbe, Uganda.

josephine

Image credit Javier Galeano

Josephine Katerewa, TB nurse, weighs a child in Kasangati Health Centre IV. Everyone who comes through the centre – both children and adults – is screened for TB symptoms. The Union provides technical assistance and support to this centre and many others in Uganda through the DETECT Child TB project.

raisa

Image credit Javier Galeano

Raisa, four, at the TB clinic as part of The Union’s TITI study. At the clinic, children are weighed, measured and given a TB skin test and a chest X-ray before meeting with the paediatrician. Depending on the results of her tests, Raisa will start a course of preventive therapy or TB treatment at her follow-up visit.

Richemine

Image credit Will Boase. 

One year old Richemine, photographed here with her parents during a visit to her home following her father’s diagnosis with active TB. The nurse and social worker have visited their home to check on Richemine, speak to her parents about preventive treatment to keep her healthy, and discuss The Union’s TITI study.

Roulatou

Image credit Will Boase.

Three year old Roulatou was photographed at a TB clinic in Benin with her mother as she waited for her first visit with the nurse as part of The Union’s TITI study into preventive TB therapy for children.

Safounatou

Image credit Will Boase. 

Three year old Safounatou was photographed with her mother during a visit to a TB clinic in Benin. Children in the Benin arm of The Union’s TITI study are given a six-month course of preventive therapy. They visit the nurse once a month for routine check-ups, to pick up medicine and to discuss any issues related to their treatment.