Today is World TB Day, and while we have made great progress to control and cure TB, we must recognize that there is still more that needs to be done. TB remains an urgent public health problem in many parts of the world, often affecting the most vulnerable. In 2012, a total of 8.6 million people became ill with TB and 1.3 million died from the disease globally. TB is a leading cause of death among women worldwide, and has orphaned 10 million children in the past decade. In countries with a high burden of TB, it is also a leading cause of death among children, claiming the lives of more than 200 children each day.
That’s why today is important. World TB Day gives us another chance to renew our determination to work even harder to reach the ultimate goal – eliminating the disease.
The reasons aren’t difficult to find.
TB often affects an entire family; TB in a child represents recent and ongoing transmission of TB bacteria in the household or community. Once infected with TB bacteria, young children are at greater risk of progressing more quickly than adults to disease, and often suffer from severe forms of TB disease. At the same time, diagnosing TB disease among young children is more challenging because the most widely available laboratory tests perform poorly among children, detecting fewer than 30% of TB cases.
TB among children has been called a “hidden epidemic.”
The disease frequently goes undiagnosed and therefore underreported. The World Health Organization’s best estimates suggest at least 10% of TB cases worldwide are among children, but the number may be as high as 20%.
Addressing this hidden epidemic has been the recent focus of a broad and growing coalition of U.S. government agencies, international and non-profit organizations, and private sector partners. In October 2013, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), in collaboration with many other partners, launched the first action plan to address TB in children.
The Roadmap for Childhood TB: Towards Zero Deaths outlines actions to accelerate progress against this deadly disease. These actions include the following.
- Empower healthcare workers to “Think TB” through training and access to childhood TB screening tools.
- Integrate TB screening into existing family, community, and health services.
- For every adult TB case, look for exposed children through contact tracing.
- Provide therapy to prevent TB among children at high-risk of developing disease.
- Collect and report more accurate data about TB in children to enable improved approaches.
- Invest in developing new clinical tools, including child-friendly diagnostics and medicines.
At CDC, we have been partnering with other U.S. government agencies, international organizations, and ministries of health to find the best ways to develop innovative approaches to diagnosing TB in children, while making the best use of available tools to reach children at-risk for TB.
CDC collaborates with communities and healthcare workers in Ethiopia, Kenya, South Africa, and Uganda to improve TB case-finding and patient outcomes.
A community-wide approach to TB prevention, case finding, and supportive care is essential to ensure all children with TB receive accurate, timely diagnosis and effective treatment and eliminate TB deaths among children.
Hope is the human face for why these efforts are important. Hope was an 8-month-old baby girl in Kenya who was very ill—she was losing weight and her mother, who was also ill, didn’t know what was wrong. Despite visits to healthcare providers, Hope’s condition was not improving. She was so ill that her neighbors began raising money to allow the mother and child to take one last visit to their home village.
Hope’s mother, determined to do everything she could, took baby Hope to a community health center, where she was quickly diagnosed with TB based on a simple clinical screening.
As part of a program developed by CDC and local partners, a community volunteer began visiting the family to ensure Hope was taking and tolerating all of her medications. The community volunteer also recognized that Hope’s mom had signs and symptoms of TB. After Hope’s mom was diagnosed with TB, she also started treatment while receiving daily support from the volunteer. Today, baby Hope has gained weight, and both she and her mother have been cured of TB and are healthy.
As we raise awareness of childhood TB and encourage community and child health services to integrate TB into their programs, we must also emphasize the importance of collecting better, routine data to help us understand this epidemic and how best to address it.
TB is preventable. And it is treatable. Every child who dies from TB is one child too many.
For more information on CDC’s role in national and global TB control, visit http://www.cdc.gov/tb.
For CDC World TB Day resources, visit http://www.cdc.gov/TB/events/WorldTBDay/default.htm.
For more information about the WHO’s plan for addressing childhood TB, visit Childhood TB Roadmap: Toward Zero Deaths.