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Positive trend, but many children still die from TB

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The World Health Organisation (WHO) has released its 2015 Global TB Report, revealing there were 1-million cases of TB among children worldwide, with 140 000 children dying from tuberculosis in 2014.
While this is double the estimate of childhood TB deaths compared to last year’s WHO report, the Desmond Tutu TB Centre (DTTC) at Stellenbosch University says it’s positive in that at least more cases are being reflected. Many childhood tuberculosis cases simply went unreported before.
“In the past cases have been widely under-estimated.  To see these kind of numbers is a huge advance. Although it sounds negative, you need to know something to do something about it,” says Anneke Hesseling, the director of the Paediatric TB Research programme at the DTTC in the university’s Department of Paediatrics and Child Health.
“The higher number means hopefully there will be more action while children who have TB will be prioritized and given the attention they deserve,” says Hesseling.
In South Africa, children make up 10% of all TB cases. Almost 40 000 cases of childhood TB were reported in South Africa in 2013, says Hesseling, although she estimates that there are probably many more.
“There’s a huge burden of tuberculosis among children in South Africa. The cases that aren’t reported are often babies or children who may have died or tend to have severe forms of TB, such as TB meningitis.”
Despite the high statistics, particularly in South Africa, Hesseling believes there is hope for the better diagnosis and treatment of childhood TB.
“Tools to better diagnose and treat TB are being developed, and children are now able to access treatment that they were unable to before,” Hesseling earlier told a special seminar series on tuberculosis in children hosted by the Department of Paediatrics and Child Health at Stellenbosch University.
South Africa is also one of a few countries at the forefront of crucial studies to develop safer, child-friendly TB medication, and to shorten the duration of treatment from its current six months to four months.
Multidrug Resistant (MDR) TB is also being tackled, but Professor Simon Schaaf, childhood MDR TB specialist at the DTTC, says MDR TB remains a crisis.
“We need new and faster diagnosis and shorter courses of drugs without injectables, which can lead to hearing loss in children,” he says.
Prevention is also essential. TB frequently spills over into children from adults. Hesseling says there’s a great need to spread the awareness of prevention therapy in the form of the drug, isoniazid, which can prevent TB in children at risk of being infected by family or household members.