Let’s Talk About Childhood TB

by Naoshin Afroz & Tristan Bayly

No child should die of tuberculosis (TB) and yet each year at least 1 million children get sick with TB and over 465 die each and every day.

TB in children can be prevented, diagnosed and cured, but children with TB are often overlooked and remain uncounted and untreated. This happens because children do not have access to diagnosis or treatment for TB, and in 2016, of the estimated 37,000 child TB cases in Bangladesh, only 9,291 (25%) cases were notified.

Patient evaluation using the mobile phone app — Photo: Shehzad Noorani

In order to narrow this gap, the USAID-funded Challenge TB project in Bangladesh began active child TB screening in the pediatric outpatient departments of six selected health facilities. Five of the facilities are in the capital Dhaka and one is in Sylhet a city in the northeast of the country.

To capture screening data electronically, Challenge TB developed an app which incorporated screening tools for child TB and staff were trained on the electronic data system. The project is also developing an animated video on child TB as part of advocacy, communication, and social mobilization activities.

With the screening system set up across facilities, children are now immediately screened for TB when they enter the facility and those that have TB symptoms are then evaluated by a doctor.

This is allowing children to be diagnosed earlier and therefore stops the further spread of the disease as those with TB are immediately put on appropriate anti-TB medication. The contacts of the children with TB (e.g. family and friends) are also checked by visiting the houses of the children who have TB, and those that are eligible are initiated on isoniazid preventive treatment (IPT).

Child with TB symptoms being evaluted by a doctor — Photo: Shehzad Noorani

From April to June 2017, a total of 74,545 children were screened and 2,262 children with TB symptoms were tested. A total of 57 children with TB were ultimately identified and all of them are now on treatment.

The success of this pilot demonstrates a clear need for better TB diagnosis and treatment. Providing access, tools, and support to children and their families is the only way for to make sure no child dies from a disease with a known cure.

In order to reach more children and to find even more of the missing childhood TB cases, screening is currently being expanded to more facilities across the country.

For more information on Challenge TB visit www.challengetb.org

Challenge TB is a USAID-funded project that aims to prevent the transmission and disease progression of TB, improve patients’ access to TB care services, and strengthen TB platforms. IRD is part of the consortium implementing the project and implements activities in Bangladesh.