As childhood tuberculosis (TB) reflects recent transmission, its burden provides an accurate measure of the level of TB control achieved in a particular community. Moreover, infected children represent the main reservoir of Mycobacterium tuberculosis (MTB) as potential future cases. However, childhood TB is neglected by scientists, policy makers, healthcare professionals and product developers [1]. Moreover, the interests of individual patients and public health may be conflicting. As children are considered in the majority of cases as noncontagious, asymptomatic disease is frequently ignored [2]. This is why, in 2013, the World Health Organization (WHO) developed a roadmap aiming to achieve zero deaths due to childhood TB by 2025 [3]. This article aims to highlight the underestimated reality of childhood TB, emphasising improved diagnosis possibilities and new treatment modalities, and advocating for dedicated paediatric operational research and clinical trials.
Methods
Active scanning of the recent literature using the keywords: “children tuberculosis”, “latent tuberculosis infection”, “new diagnosis tools” and “treatment modalities” was performed using PubMed and EMBASE. In addition, International Union Against Tuberculosis and Lung Disease publications were screened and WHO policy and guidance documents on TB were obtained from the WHO website (http://www.who.int).
Epidemiology
Each year, more than 74 000 children die from TB [3]. Exposure to an adult with pulmonary TB was reported to increase mortality by 70% in children under 5 years of age in high-burden settings and by eight-fold when the mother had TB [4].
The global burden of childhood TB is under-reported due to paucibacillary disease and the difficulty of confirming the diagnosis. In China, the prevalence rates for bacteriologically positive pulmonary TB and smear-positive cases were eight and 13 times less than the clinically diagnosed pulmonary TB rate, respectively [5]. TB disease and latent TB infection …
