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 Overall, as many as 1 million children become sick
with TB each year, about twice the number previously thought, and of
these, only a third of the cases are ever diagnosed, the study
found.
"A huge proportion (of children) are suffering and dying from TB
unnecessarily," said Helen Jenkins of Brigham and Women's Hospital's
Division of Global Health Equity, the lead statistician on the study
published on Sunday in the Lancet.
The findings, published as part of a special theme issue of Lancet
to commemorate World TB Day on March 24, offer the clearest picture
yet of the global burden of tuberculosis among its youngest victims,
and for the first time estimate the burden of multidrug-resistant
tuberculosis or MDR-TB.
"Despite children comprising approximately one quarter of the
world's population, there have been no previous estimates of how
many suffer from MDR-TB disease," said Dr Ted Cohen, also of the
Harvard-affiliated Brigham and Women's Hospital, and a co-author on
the paper.
For decades, researchers had largely ignored tuberculosis infections
in young children, in part because children are less likely to
transmit the disease than adults.
TB infections are especially hard to diagnose in children because
the infection looks different in children than adults.
The disease is caused by bacteria that typically attacks the lungs
and is often spread through the air when people who have an active
infection cough.
Tuberculosis typically attacks the lungs and is spread through the
air when people who have an active infection cough.
"In kids, you are much more likely to have TB disease in other parts
of the body, not necessarily in the lungs," Jenkins said. Even when
children do have TB in their lungs, there are fewer TB pathogens
present, "making kids with TB invisible" to current diagnostic
methods, she said.
To arrive at their estimates, Jenkins and colleagues scoured
publicly available databases and devised a way to correct for
chronic underreporting of TB in children.
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"What we
found was that whereas previous estimates for the total number of TB
cases in kids were about half a million, when you account for
(underreporting) in your estimates, it's more like 1 million
children develop active TB disease every year," she said.
The World Health Organization estimates that 8.6 million people
developed TB in 2012 and 1.3 million died from the disease.
According to the WHO, half a million people became sick with
dangerous superbug strains of tuberculosis in 2012, it estimates
that up to 2 million people worldwide may be infected with
drug-resistant TB by 2015.
Keeping track of TB rates in children is important for two
reasons, Jenkins said. First, children with drug-sensitive forms of
TB generally respond very well to treatment.
Second, because TB disease develops very quickly in children, often
within weeks of exposure, finding an infected child can offer key
clues about TB transmission within a community.
"That's telling you you've got some kind of system failure going on
there," Jenkins said.
She said the findings illustrate the need for better methods of
collecting data on childhood TB, including better diagnostics and
more systematic data collection.
(Reporting by Julie Steenhuysen; editing by Andrew Hay)
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