Tuberculosis (TB) is one of the top ten killers of children and infants worldwide. Globally, it is estimated that up to 210,000 children die of TB each year and a million are infected, according to World Health Organization (WHO).
Children with TB are less likely to be infectious than adults, which is why childhood TB has not been a priority within national healthcare programs. Young children are at particular risk of developing severe, often fatal or lifelong disabling forms of TB. If children are living with HIV they are even 20 to 30 times more likely to develop TB than children who are not infected with HIV.
“No generation should grow up with a latent TB “time bomb” that could later be transmitted to other generations.” – Agnes Gebhard (KNCV consultant)
Once diagnosed, TB in children is not difficult to cure. But TB drugs are not yet available in a child-friendly formulations e.g. liquid form, and the tablets for adults are much too large for young children to swallow. Sometimes pills intended for adults are used (in crushed form), which carries the risk of an under-dosage or over-dosage for a child.
In 2016, the Kenyan government started to roll out the first child-friendly TB drugs which have a smaller dosage and better taste, this development provides hope but much work is still ahead.
KNCV Tuberculosis Foundation and its partners believe that the fight against childhood TB should be a high priority in global health. For example, we need to integrate TB services into general child healthcare programs. We are doing our utmost to improve the prevention, diagnosis and treatment of TB among children. But childhood TB presents specific challenges. We need to address these with appropriate measures, which include screening children for TB, improved diagnostics and latent TB preventive therapy.
Childhood TB Roadmap
In 2013, WHO launched a global Childhood TB Roadmap, outlining the path towards zero deaths from childhood tuberculosis. The “Roadmap for Childhood TB: Toward Zero Deaths” is a call to action for all stakeholders in child health. It recommends ten actions to be taken at national and global levels.
KNCV is now supporting countries to develop a national “roadmap” or TB management strategy. We have created a self-assessment tool to help countries to compare their childhood TB policies with standards and benchmarks according to the latest WHO guidelines on childhood TB, and determine steps to be taken to strengthen TB care in children: the KNCV Benchmarking Tool for Childhood TB Policies, Practices and Planning, which can be downloaded here. The tool has already been used in Vietnam, Ethiopa, Bangladesh, Indonesia, Ukraine, Kyrgyzstan, Malawi and the Netherlands.
Developing knowledge, policies and capacity
KNCV is actively assisting countries to understand childhood TB and develop their capacity to deal with the disease.
This includes helping to measure the infection rate and disease among children. For example, we have experience in guiding cohort studies on TB prevalence and studying disease incidence in infants and adolescents, to prepare for vaccine trials. These studies give us new insights that help us advise on treatment of active disease and latent TB with improved childhood TB diagnostic algorithms and TB case-finding strategies.
KNCV continues to invest in the quality diagnosis and treatment of children with TB, and improving notification of childhood TB.