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October 01, 2013

Stopping Childhood TB Deaths

by Joe DeCapua

Tuberculosis kills more than 74-thousand children every year. But health officials say those deaths are preventable. The World Health Organization and its partners have released a roadmap outlining the steps needed to end childhood TB deaths.


The roadmap says the urgency of the TB problem in children cannot be underestimated. Dr. Mario Raviglione, director of the WHO’s Global Tuberculosis Program, said, “The perspective we have of the TB issue, the TB problem, in children is today not, I would say, fully complete. It has proven quite difficult to estimate what the burden is for a number of technical reasons.”

Children account for about 500,000 new cases every year. But the number could be much higher because is difficult to diagnose the disease in kids.

“It is not the normal way of presenting tuberculosis like among adults – where the majority of patients will have fever, cough, night sweats, weight loss and so on. In children, it may appear in a more subtle way. And children tend not to have a lot of these pulmonary symptoms, lung symptoms that in fact are typical of tuberculosis in the adults. So if you don’t really suspect it – and if you don’t go after it – you may easily miss the diagnosis,” he said.

The Roadmap for Childhood TB: Toward Zero Deaths is a joint effort that includes the WHO, the U.S. Centers for Disease Control and Prevention, UNICEF, USAID and a number of NGOs.

Raviglione said that the response must be tailored-made for children.

“Starting with the notion that everything that is done in tuberculosis control and care, in general, among adults and so on, needs to be now much more sensitive to the special needs that you have in children – whether we’re talking about surveillance, reporting of the cases, the diagnosis, the treatment of the case or the research in tuberculosis in children. Everything has to be in a way re-thought in such a way that it becomes children-sensitive, and we can advance in our knowledge and our understanding of the problem.”

Raising awareness about childhood TB is made more difficult because most of those infected are poor.

He said, “In developing countries, in poor areas, tuberculosis can really hide in the favelas of Rio de Janeiro or in the rural villages of Africa without people being aware of what it is. And where you have poor access to care, poor access to clinics, to hospitals, etcetera, becomes more difficult. And so what happened there is that children probably deteriorate progressively and eventually die without ever having a diagnosis of tuberculosis established.”

It’s estimated it would cost $120 million a year to implement the TB roadmap. Raviglione said it’s a small price to pay to stop children from dying from TB. 

The roadmap does report good news at the country level. It says there’s been “a significant transformation of political will and commitment to intensify efforts to address TB among children.”