Study finds high risk of pediatric tuberculosis in high-burden areas

New findings also indicate that children who live in settings with a high burden of TB have a consistently high annual risk of developing TB infection throughout childhood.

An estimated 1.2 million children develop tuberculosis disease (TB) and 200,000 kids die from TB worldwide each year, but the risk of developing TB infection and disease throughout childhood remains under-studied. Furthermore, the majority of studies on the pediatric burden of TB are informed by data from patients in healthcare settings, rather than people in real-world, community settings.

Published in The Lancet Child & Adolescent Health, the study is the first birth cohort study to assess TB infection and active TB disease during children's first decade of life in high-burden settings. The new results found that there was a consistently high rate of annual TB infection among children in the study group-;between 4-9 percent-;and that more than 10 percent of children developed TB disease by the time they were 10 years old. The study builds upon a previous analysis by some of the researchers which also found high rates of TB infection and disease in children up to five years old.

"Despite reasonable nutrition and almost no children living with HIV, there was an extraordinarily high, concerning rate of TB infection and disease in this cohort," says co-senior author Dr. Heather Zar, principal investigator of the Drakenstein Child Health Study. Many children with TB disease were diagnosed when they presented with acute pneumonia, suggesting that in areas of high TB prevalence, children with pneumonia should be investigated for TB."

Much work still needs to be done to tackle the pediatric tuberculosis epidemic in South Africa and other high-burden countries, Dr. Martinez says. "If we are to reduce pediatric tuberculosis globally, a multisectoral approach is needed that brings together researchers, policymakers, healthcare workers, funders, and advocates to find comprehensive solutions."

The study's lead author is Dr. Fernanda Bruzadelli Paulino da Costa of the University of São Paulo. Coauthors include Dr. Mark P. Nicol, Maresa Botha, and Lesley Workman of the University of Western Australia, and Ricardo Alexandre Arcêncio of the University of São Paulo.

Source:

Boston University School of Public Health

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