TB in Children (Global Perspective)
In many countries, tuberculosis (TB) disease is much more common than in the United States. In countries with a high rate of TB disease, TB in children is also much more common.
A Hidden Epidemic
The World Health Organization (WHO) estimates that every year:
- Childhood TB accounts for 6% to 10% of all TB cases worldwide;
- In countries with a high rate of TB disease, children account for as much as 40% of all new TB cases;
- At least half a million children worldwide get sick with TB disease each year; and
- More than 74,000 children die from the disease each year.
Unfortunately, these figures underestimate the burden of childhood TB worldwide. TB in children has been a “hidden epidemic” for many years because of a number of challenges.
- Childhood TB is particularly difficult to diagnose in resource-poor settings and is often not reported to health authorities in many countries.
- Many children cannot cough up sputum for TB testing. Even when sputum from a child is available, the least expensive tests can diagnose only about 30% of cases.
Childhood TB is Preventable and Treatable
TB in a child represents recent and ongoing transmission of TB bacteria. Young children are most likely to become exposed and infected with TB by close contacts, such as family members. Children can develop TB disease at any age, but the severe forms of TB are most common among children between 1 and 4 years of age. Children can get sick with TB disease very soon after being infected with TB bacteria, or they can get sick at any time later in life. They can even infect their own children, decades later, if not treated.
TB in adults and children is curable if identified and treated appropriately. Children at risk of developing TB disease can be identified using simple methods and screening tools. Many children with TB disease can be diagnosed with a clinical evaluation by a trained health care worker.
There are many tools available that can help prevent, find, and treat TB among children. CDC, in partnership with the World Health Organization (WHO), the global Stop TB Partnership, and other U.S. Government agencies, is working to raise awareness of this hidden epidemic. We are also working together to ensure the right tools are in the hands of families, communities, and health care workers to identify children at-risk for TB and link them to appropriate care.
CDC’s Role in Addressing Childhood TB
CDC TB experts participate in technical working groups at WHO, Stop TB Partnership, and across U.S. Government agencies to develop global guidance on management of childhood TB. CDC’s Division of Tuberculosis Elimination collaborates with national TB programs in nine countries to
- Train clinicians on simple methods to screen and diagnose TB among children,
- Conduct research to find the best ways to use existing tools,
- Strengthen surveillance systems to better understand the burden of TB among children, and
- Prioritize childhood TB through policies and guidance focused specifically on addressing the needs of children.
Examples of CDC’s work to address childhood TB include:
- Working with the national TB program of Kenya to look for the best approach to screen children for TB; this includes using simple criteria to identify children who need further evaluation. CDC is also evaluating the performance of the new Xpert MTB/RIF® test in diagnosing TB among children, which could make TB diagnosis better and faster.
- Training clinicians in Uganda on the use of the international desk-guide for diagnosis and management of childhood TB. CDC is collaborating with the national TB program of Uganda to evaluate the guide’s impact on finding and treating children with TB. This evaluation will help inform future use of the guide by national TB programs to put the right tools in the right hands to reach children most at-risk.
- In South Africa, completing the largest study ever conducted to characterize drug-resistant TB among children. As part of this project, CDC partnered with clinicians, researchers, and government staff who are global leaders on childhood TB to identify ways the South African community can address this problem through research, policy change, training, and funding.
CDC will continue to raise awareness of TB in children, build the knowledge and evidence base to better understand this epidemic, and identify the best tools to fight it.
- Clinical Management of TB in Children Outside of the United States
- TB in Children in the United States