Bringing Childhood TB into Main stream

Chhatra Karki, Nepal 
(First published in Kapan Online, Nepal, 14 October 2013) 
The ‘Roadmap for childhood TB: Toward zero deaths’ brought out by the International Union against Tuberculosis and Lung disease (The Union), World Health Organization (WHO), Stop TB Partnership and other institutions, has not come a day too early. It is indeed high time for countries to prioritise implementation of childhood TB programmes  and take effective steps to prevent this curable disease from taking the lives of 72,000 children around the globe each year.

The Roadmap rightly demands that priority in treatment should be given to children infected by TB and that primary health centres should be a key component of health services in delivering TB care and control in children.

According to the Nepal Tuberculosis Centre, among 40,000 people infected with TB, 10% are children. Amongst the children suffering from TB, around 14% are dying. However, priority has not been given to childhood TB. Dr. Deergha Singh Bom, senior chest disease and TB expert, says that Pulmonary TB (PTB) and Extra Pulmonary TB (EPTB) are found in children. PTB causes infection in chest and lungs and EPTB causes infection in bones, stomach and glands. Dr. Bom says, …there has been improvement in the state of TB patients in Nepal. DOTS treatment system is also improving. However, as childhood TB is difficult to diagnose, many children are dying by this disease.’

Children in a family incur PTB infection from adults in Nepal. Unhealthy children and children suffering from mal-nutrition are also found infected by TB. HIV AIDS infected children are ten times more likely to be infected by TB. Yet it is very difficult to diagnose TB in children. X-ray, biopsy and TB culture diagnosis facilities are not available in remote parts of Nepal. In remote places, general health services are very poor. In many villages even the BCG vaccine has not been made available yet. Dr. Bom says, ‘there are many people still uneducated, they don’t know TB can be cured with timely treatment. They don’t take a TB infected child to a hospital.’

According to the National Tuberculosis Centre, there is no separate government programme in Nepal to control childhood TB. Treatment of the infected children is carried out in the same way as for adults. Dr. Bom insists that there should be  different programme targeted towards TB infected children.

International Union against Tuberculosis and Lung disease (The Union), World Health Organization (WHO), Stop TB Partnership and other institutions have declared ‘Roadmap for childhood TB: Toward zero deaths.’

‘Childhood TB should be diagnosed utilizing the available resources. Needful equipments and medicine should be available to community health workers and programs should be launched to reduce childhood TB,’ The  director of Center for Global Health at the US centers for Disease Control and Prevention Dr. Pom Kenym says, ‘it should be insured that community health and children centered health services should be given priority.’

Chhatra Karki, Nepal 
Citizen News Service - CNS
(First published in Kapan Online, Nepal, 14 October 2013)