Roadmap for Childhood TB: Towards Zero Deaths

Chhatra Karki, Nepal
(First published in Kapan Online, Nepal) 
More than 74,000 children are dying each year by tuberculosis all over the world. In this context, a lucid roadmap has been declared by International Union Against Tuberculosis and Lung Disease (The Union), World Health Organization (WHO), Stop TB Partnership and many other leading agencies of the world who are fighting against this disease. It is estimated that 120 million US dollar will be spent to eliminate childhood tuberculosis and tuberculosis with HIV infection.

According to the WHO, 250 Children below 15 are dying everyday though there are security measures and permanent cure available against tuberculosis.’Among the infected people, 10-15 percent are children,’ says the WHO report. Termed as ‘Roadmap for Childhood Tuberculosis: Towards Zero Deaths’, this project will save children from dying by tuberculosis. This roadmap should be widely implemented as 175 countries of the world have already signed on the international convention on protecting children from untimely death caused by TB and similar diseases.

Tuberculosis can be prevented and cured. The roadmap has declared that each and every challenges will be tackled to eliminate this disease in children. ‘In addition to focusing maternal and child health program, priority should be given to tuberculosis diagnosis and treatment program. This will surely give positive result,’ Interim executive director Jose’ Luis Castro of International Union Against Tuberculosis and Lung Disease (The Union) further says, ‘Thousands of children’s lives can be saved if we invested enough money in the preventive measures, instruments and medicine.’

The Roadmap prescribes ten actions to be taken at national and global levels to eliminate the tuberculosis.
1. Include the needs of children and adolescents in research, policy development and clinical practices.
2. Collect and report better data, including preventive measures.
3. Develop training and reference materials on childhood TB for health-care workers.
4. Foster local expertise and leadership among child-health workers at all levels of the health-care system.
5. Use critical intervention strategies, such as intensive case finding, contact tracing and preventive therapy; implement policies enabling early diagnosis; and ensure there is an uninterrupted supply of high-quality anti-TB medicines for children.
6. Engage key stakeholders, and establish effective communication and collaboration between the health-care sector and other sectors that address the social determinants of health and access to care.
7. Develop integrated family- and community-centered strategies to provide comprehensive and effective services at the community level.
8. Address research gaps in the following areas: epidemiology, fundamental research, the development of new tools (such as diagnostics, medicines and vaccines); and address gaps in operational research and research looking at health systems and services.
9. Close all funding gaps for childhood TB at the national and global levels.
10. Form coalitions and partnerships to study and evaluate the best strategies for preventing and managing childhood TB, and for improving tools used for diagnosis and treatment.

Extra pulmonary TB (EPTB) has been more challenging than pulmonary TB (PTB) in Nepal. Senior Chest and TB Specialist Dr. Birgha Singh Bam says, ‘Lymphadenopathy, Tubercular mouingitis, Tuberculoma, TB Mephritis, TB abdomen and TB bone has been diagnosed in children in Nepal.’ He further says, ‘this disease is detected in children with malnutrition and other health problems. Though the overall scenario of TB infection has been improved, screening condition is poor. Children with HIV positive are ten times more prone to TB than normal children. Due to poverty and unawareness, TB still remains out of control in Nepal.’

According to National Tuberculosis Center (NTC), among 40,000 TB infected each year, 4,000 are children in Nepal. And among the infected fourteen percent children face untimely death. Out of total TB infected children, More than seventy percent children are infected with EPTB.

Chhatra Karki, Nepal
Citizen News Service - CNS | October 2013
(First published in Kapan Online, Nepal on 2nd October 2013) 

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