How to reach zero tuberculosis deaths among children

Photo Credit: Dr Essam Elmoghazy
Dr. Essam Elmoghazy, Egypt 
Consumption, phthisis, scrofula, Pott's disease, and the White Plague are some of the various terms used to refer to tuberculosis throughout history. Today, more than 2 billion people worldwide are infected with the bacterium that causes TB. Although most infected people do not become ill, in 2011, an estimated 8.7 million people became sick with TB, and 1.4 million people died, according to the World Health Organization (WHO). WHO also revealed that up to 74 000 children die from TB each year and children account for around half a million new cases annually.

In Egypt 8145 tuberculosis patients were notified in 2012. Among them 550 (7%) were under 15 years old. Males represented 53% of cases while females represented 47%. “Childhood TB prevention, diagnosis and treatment need to become not only a higher priority within existing TB services, but also integrated into broader child and community health systems. The tragedy here is that countless opportunities are lost to find and treat TB in children early, when young lives can still be saved,” said José Luis Castro , interim Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union).

 To lead the fight against childhood TB, the World Health Organization (WHO), Stop TB Partnership and the Union, along with many other partners such as the US Centers for Disease Control and Prevention and US Agency for International Development, released a roadmap to end deaths from childhood tuberculosis.
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

Desmond Tutu, Nobel Peace Prize winner rightly thinks that, “It is a sad statement that childhood tuberculosis still kills as many children as it does. But this is an eminently solvable problem. All that the world needs is a more aggressive commitment to end the disease.”

According to the roadmap, the goal of reaching zero TB deaths among children worldwide is within our grasp. Achieving this requires sustained advocacy, greater commitment, mobilization of increased resources and a joint effort by all stakeholders involved in providing health care for children and in TB control.

Dr. Essam Elmoghazy, Egypt 
Citizen News Service - CNS
October 2013

(The author is the Chairman of the Association against Smoking , Tuberculosis and Lung diseases - Cairo)