Missed childhood TB cases impede achieving 2025 goal

Subject: Science and technology

Section: Health

Context:

With childhood TB continuing to remain a “staggering problem” in India, “eliminating” TB by 2025 might be extremely challenging.

Cases of TB:

Globally, TB is now regarded as the leading cause of death from infectious diseases for children of all ages.
The estimated mortality of children with TB who fail to receive treatment is about 22%.
The case fatality ratio in children less than five years is 43%.

Critical gaps in TB case detection:

According to the WHO, there are critical gaps in detecting TB cases among children.
Globally, at least 1.2 million children aged less than 15 years fall ill with TB every year, and around 67 million children get infected.
56% of the 1.2 million children who develop TB annually are not detected.
As per the 2022 WHO global TB report, last year, children aged less than 15 years across the world accounted for 11% of the total estimated incident TB cases.

Cases in India:

India contributes nearly one-third to the global childhood TB caseload.
Nearly 0.34 million children aged less than 15 years are estimated to get TB disease every year; children in this age group in India are estimated to contribute about 13% of the TB caseload.
But in 2022, only 1,35,734 children were notified. Thus over 2,00,000 (about 60%) children with TB were likely missed last year alone.
Though children are required to be tested using highly sensitive molecular tests at the first point of contact, smear microscopy is often used.
In 2022, of the 3,00,000 molecular tests performed on children, just 37,000 (12%) were bacteriologically confirmed.
While the number of TB cases notified in India has increased since 2015, notifications of childhood TB have remained constant at 6%. each year.
Even as the bulk of the cases in children is pulmonary TB, which is easier to detect, up to 32% of TB cases are extrapulmonary, which makes TB detection more challenging.
There is a reduction in BCG vaccination of children during the pandemic.