Global Burden of Childhood Tuberculosis.

Helen E. Jenkins

doi:10.1186/s41479-016-0018-6

Abstract

In 2015, the World Health Organization (WHO) declared tuberculosis (TB) to be responsible for more deaths than any other single infectious disease. The burden of TB among children has frequently been dismissed as relatively low with resulting deaths contributing very little to global under-five all-cause mortality, although without rigorous estimates of these statistics the burden of childhood TB was, in reality, unknown. Recent work in the area has resulted in a WHO estimate of 1 million new cases of childhood TB in 2014 resulting in 136,000 deaths. Around 3% of these cases likely have multidrug-resistant TB and at least 40,000 are in HIV-infected children. TB is now thought to be a major or contributory cause of many deaths in children under five years old, despite not being recorded as such, and is likely in the top ten causes of global mortality in this age group. In particular, recent work has shown that TB is an underlying cause of a substantial proportion of pneumonia deaths in TB-endemic countries. Childhood TB should be given higher priority: we need to identify children at greatest risk of TB disease and death and make more use of tools such as active case-finding and preventive therapy. TB is a preventable and treatable disease from which no child should die.

Highlights

In 1963, Edith Lincoln and Edward Sewell wrote in their seminal book ‘Tuberculosis in Children’: “At the present time the death rate from tuberculosis is markedly reduced in some areas and it is possible to look forward to the day when tuberculosis will no longer be a public health problem [1].” More than 50 years later, in 2015, the World Health Organization (WHO) declared tuberculosis (TB) to be the number one killer among infectious diseases [2].The underlying reasons for this resurgence are complex
Applying this to the WHO pediatric TB incidence estimate would indicate that 514,000 children under five years of age developed TB disease in 2014, which is nearly four and half times the number notified to the WHO for that year [28]
An alternative method of estimating the number of children dying with TB is to multiply case fatality ratios (CFR; which could be defined in this context as the percentage of children that die within a year of a TB diagnosis) by the estimated incidence of pediatric TB

Summary

Introduction

In 1963, Edith Lincoln and Edward Sewell wrote in their seminal book ‘Tuberculosis in Children’: “At the present time the death rate from tuberculosis is markedly reduced in some areas and it is possible to look forward to the day when tuberculosis will no longer be a public health problem [1].” More than 50 years later, in 2015, the World Health Organization (WHO) declared tuberculosis (TB) to be the number one killer among infectious diseases [2].The underlying reasons for this resurgence are complex. Dodd et al estimated that 51.4% of all pediatric cases of TB disease in 2014 occurred in children under five years of age [21] (Table 2).

Results

Conclusion