Regional initiatives to address the challenges of tuberculosis in children: perspectives from the Asia-Pacific region

Abstract

Increasing attention is being given to the challenges of management and prevention of tuberculosis in children and adolescents. There have been a number of recent important milestones achieved at the global level to address this previously neglected disease. There is now a need to increase activities and build partnerships at the regional and national levels in order to address the wide policy-practice gaps for implementation, and to take the key steps outlined in the Roadmap for Child Tuberculosis published in 2013. In this article, we provide the rationale and suggest strategies illustrated with examples to improve diagnosis, management, outcomes and prevention for children with tuberculosis in the Asia-Pacific region, with an emphasis on the need for greatly improved recording and reporting. Effective collaboration with community engagement between the child health sector, the National Tuberculosis control Programmes, community-based services and the communities themselves are essential.

Epidemiology of childhood tuberculosis and factors associated with unsuccessful treatment outcomes in Tigray, Ethiopia: a ten-year retrospective cross sectional study

“…The reason could be misconceptions in the community like that infants and young children are a particular low risk group for severe disease because materials that informs about the specific challenges of tuberculosis in children which support community engagement are little. As well contact screening by health workers could be low in the region [22] and the uncomfortable diagnostic procedure of TB for children.…”

Examining the quality of childhood tuberculosis diagnosis in Cambodia: a cross-sectional study

“…With an estimated half a million new cases, and 74,000 deaths, annually, childhood tuberculosis (TB) is emerging as a top global health priority, after years of being overshadowed by attention toward adult TB interventions [1, 2]. Compared to adult TB, TB in children under age 15 presents symptoms that are difficult to detect [3, 4].…”

Child pneumonia – focus on the Western Pacific Region

“…High incidence rates are indicative of poor epidemic control and since children develop disease in settings where adults spread the infection, Figure 2 indicates areas where M. tuberculosis is likely to be an important lung pathogen in children. The WHO estimated that one million children developed tuberculosis in 2014 [47], but case detection is a major challenge [48]. Tuberculosis is rarely considered in young children presenting with acute severe pneumonia, although its presence as a primary cause or co-infection is well documented in these cases [49,50].…”

“…Of 103 children (<15 years) diagnosed with tuberculosis in Northern Viet Nam, most were in the 5-14 year age range [54], suggesting gross under-detection in young children who are known to be most vulnerable [55]. Following a successful proof-ofconcept study in 4 provinces [48], the Viet Nam National Tuberculosis Control Program plans to expand community-based contact screening and provision of preventive therapy to all provinces by 2020.…”