Childhood and adolescent TB
Addressing childhood and adolescent TB is essential to halt the TB epidemic
In the WHO European Region, more than 7200 children and adolescents under 15 years of age account for about 4% of notified new tuberculosis (TB) patients (2016 data). Of them, 87% live in 18 high-priority countries where TB is a major problem.
Prevention, diagnosis and treatment of TB in children and adolescents has been a neglected aspect of the global TB epidemic over the past years as they were thought to play only a minor role in transmission and spread of the disease. Current evidence instead suggests the following:
- Under- and misdiagnosis of TB in children and adolescents is common and of concern, especially in children under 5 years of age.
- Active TB in children is a sentinel event suggesting recent transmission among adults. In fact, paediatric TB is most often contracted from an infectious adult at home.
- Children and adolescents with latent TB infection represent a reservoir for further transmission to other family members.
Towards zero childhood and adolescent TB deaths
The goal of zero TB deaths among children and adolescents, endorsed by the international child health and TB community, can only be achieved through collaboration across sectors, health systems and all stakeholders involved in child health.
Prioritizing childhood and adolescent TB in national health strategies, plans and budgets is critical to addressing key shortcomings in childhood and adolescent TB care. The Tuberculosis Action Plan for the European Region 2016–2020 requests Member States to develop plans that ensure equitable access to quality treatment and continuity of care, including for children, as part of their interventions on integrated, patient-centred care and prevention.
Key challenges for childhood and adolescent TB in the European Region
- Despite new WHO recommendations for childhood TB treatment regimens, child-friendly formulations are not yet fully available to match the recommendations.
- Procurement of all routinely used TB drugs in child-friendly formulations where available is not always ensured.
- Diagnostic capacity to deal with the specificities of child samples is inadequate.
- Specific guidance on childhood and adolescent TB is lacking in national TB programmes.
- Unnecessary hospitalization, often due to clinical practices for treatment and prevention of active TB disease and transmission, keeps children and adolescents away from their families.
- Data on childhood and adolescent TB are not always recorded systematically; little information or data are available on multidrug-resistant TB (MDR-TB) and TB/HIV coinfection in children and adolescents.
- There is insufficient awareness of childhood and adolescent TB among family physicians and paediatricians.
