New study estimates TB mortality rates in children under 5

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In a new study, from the University of Sheffield (UK) and collaborators, the global tuberculosis (TB) rate in children under 5 has been reported for the first time. The research estimates that 239,000 children under 14 years old died from TB in 2015; moreover it reports that 80% of these deaths occurred in children under 5 and that over 96% of the fatalities were in children not receiving treatment.

Diagnosing TB cases in children is a challenging task owing to the intensive nature of diagnsotic tests and non-specific disease symptoms. Therefore, despite young children being at high risk of severe TB, there have previously been no estimates of mortality rates in infants under 5 years old. Although under-five mortality is considered a key indicator in both the Millennium Development Goals and the Sustainable Development Goals, TB has never been explicitly included in either. This study, published recently in The Lancet Global Health, therefore aimed to produce the first global mortality estimates for the pediatric population.

The researchers used data from the WHO, including pediatric notification figures and estimates on HIV and antiretroviral treatment, to tease out tuberculosis incidences by age, HIV and treatment status. The team then employed a mathematical modelling approach to estimate the mortality rates in both the under-fives and children aged 5–14 years for 217 territories and countries.

Overall the study reports that an estimated 239,000 children aged 14 years and under died from TB in 2015, as author, Pete Dodd (University of Sheffield) explained: “We estimate 239,000 children died from TB in 217 countries in 2015 – 80% of these were children under 5 years of age. This makes TB a top 10 cause of death in the age group.

“The vast majority of deaths – over 96% – were in children not receiving treatment for the disease. Given excellent treatment outcomes, this highlights the scope to reduce this toll by improving treatment coverage.”

“Historically, TB in children has not received the attention that it might have done. The World Health Organization has been encouraging countries to report the number of TB cases they find in children by age group.”

The researchers suggest that more needs to be done in order to identify children with TB and ensure they are appropriately treated. Author, Helen Jenkins (Boston University, MA, USA) concluded: “This should be a call to action: TB is preventable and treatable and we must do more to stop these unnecessary deaths in children.”

Interested in pediatric tuberculosis? Take a look at our podcast where authors of this study Pete Dodd and James Seddon, along with  Elizabeth Whittaker and Beate Kampmann, discuss the importance of studying tuberculosis in a pediatric population; focusing on immunology, modelling and drug resistance.

Sources: Dodd PJ, Yuen CM, Sismanidis C, Seddon JA & Jenkins HE. The global burden of tuberculosis mortality in children: a mathematical modelling study. Lancet Glob. Health. 5 (9) e898–e909 (2017)

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