How do we Improve Reporting and Diagnosis of Paediatric TB?
Although the World Health Organization’s (WHO’s) latest report on tuberculosis provides welcome news on falling numbers of cases, children are still being neglected despite the fact that they represent approximately 15–20% of the global burden of tuberculosis. As Director-General of WHO, Margaret Chan, said in her inaugural speech: “what gets measured gets done”.
Difficulties in Diagnosing TB
There are many constraints to diagnosing and treating tuberculosis in children. Definitive, simple diagnostic tests do not exist, while treatment is complicated by a lack of appropriate fixed-dose combinations for children. Globally, the only indicators for children aged less than 15 years are the number of children orphaned by tuberculosis and the notification of smear-positive cases. For 22 high-burden countries, 157 135 cases of tuberculosis in children were reported in 2010. These countries have an estimated total prevalence of 9.97 million cases, meaning that at conservative estimates we should expect the number of paediatric cases to range from 498 500 (5%) to 1.49 million (15%). Even at the lowest estimate of 5%, this means that at least 341 365 cases were not diagnosed or reported in these countries.
Funding for TB Diagnosis Needs to Mirror that of HIV
The drive to increase access to treatment and prevention for people living with HIV/AIDS has been supported by clear reporting of need. By contrast, current tuberculosis reporting gives little indication of unmet need and thus there is no way of judging how far we have to go. Better reporting could provide the foundation for a much-needed drive to increase political commitment to tuberculosis funding mirroring the success of HIV activism.
How can the global health community increase access to treatment and prevention for people living with TB?
How can diagnosis of paediatric TB be improved?
For full details of MSF research into reporting and diagnosis of Paediatric TB - http://www.who.int/bulletin/volumes/89/12/11-098582/en/index.html