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Childhood TB Surveillance: Bridging the Knowledge Gap to Inform Policy.

Brent AJ - J Trop Med (2012)

Bottom Line: Improved surveillance is among the key research priorities identified for childhood TB, but progress to date has been slow.Recent advances in TB diagnostics, and standardized clinical diagnostic guidelines and case definitions, all provide opportunities for new strategies to improve surveillance.Better-quality data on the burden and trends of childhood TB will inform and improve both public health policy and clinical practice.

View Article: PubMed Central - PubMed

Affiliation: KEMRI-Wellcome Trust Research Programme, P.O. Box 230, Kilifi 80108, Kenya.

ABSTRACT
Tuberculosis (TB) is a leading cause of death globally. Natural history studies show that young children are at particularly high risk of progression to active TB and severe, disseminated disease following infection. Despite this, high-quality regional and global surveillance data on the burden of childhood TB are lacking. We discuss the unique aspects of TB in children that make diagnosis and therefore surveillance challenging; the limitations of available surveillance data; other data which provide insights into the true burden of childhood TB. Improved surveillance is among the key research priorities identified for childhood TB, but progress to date has been slow. Recent advances in TB diagnostics, and standardized clinical diagnostic guidelines and case definitions, all provide opportunities for new strategies to improve surveillance. Better-quality data on the burden and trends of childhood TB will inform and improve both public health policy and clinical practice.

No MeSH data available.


Related in: MedlinePlus

Causes of death among children under 5 years of age (data from [6]).
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Causes of death among children under 5 years of age (data from [6]).

Mentions: In 2009 an estimated 9.4 million cases of TB occurred worldwide, equivalent to an annual global incidence of 137 per 100,000 population [3]. In the same year, 1.7 million deaths were attributed to tuberculosis [3]. TB remains second only to HIV as a leading infectious cause of death globally [4]. Global estimates of the causes of death among children have also been derived [5, 6], and the latest estimates based on data from 2008 are illustrated in Figure 1 [4]. Given the overwhelming burden of tuberculosis among the population as a whole and the well-documented vulnerability of young children to active TB including the severe and fatal forms of the disease [7], it is perhaps surprising that TB does not feature among the leading causes of death in children. Protection afforded by Bacille Calmette Guérin (BCG) vaccination among infants and young children, particularly against disseminated TB and TB meningitis, provides one important explanation for this apparent discrepancy [8]. However, even in this group the protective efficacy of BCG is suboptimal, and the best available estimates suggest a high global burden of childhood TB despite wide-scale neonatal BCG vaccination within the Expanded Programme of Immunization [9]. To reconcile these data requires a clear understanding of their limitations and the underlying challenges of TB diagnosis in children.


Childhood TB Surveillance: Bridging the Knowledge Gap to Inform Policy.

Brent AJ - J Trop Med (2012)

Causes of death among children under 5 years of age (data from [6]).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3306957&req=5

fig1: Causes of death among children under 5 years of age (data from [6]).
Mentions: In 2009 an estimated 9.4 million cases of TB occurred worldwide, equivalent to an annual global incidence of 137 per 100,000 population [3]. In the same year, 1.7 million deaths were attributed to tuberculosis [3]. TB remains second only to HIV as a leading infectious cause of death globally [4]. Global estimates of the causes of death among children have also been derived [5, 6], and the latest estimates based on data from 2008 are illustrated in Figure 1 [4]. Given the overwhelming burden of tuberculosis among the population as a whole and the well-documented vulnerability of young children to active TB including the severe and fatal forms of the disease [7], it is perhaps surprising that TB does not feature among the leading causes of death in children. Protection afforded by Bacille Calmette Guérin (BCG) vaccination among infants and young children, particularly against disseminated TB and TB meningitis, provides one important explanation for this apparent discrepancy [8]. However, even in this group the protective efficacy of BCG is suboptimal, and the best available estimates suggest a high global burden of childhood TB despite wide-scale neonatal BCG vaccination within the Expanded Programme of Immunization [9]. To reconcile these data requires a clear understanding of their limitations and the underlying challenges of TB diagnosis in children.

Bottom Line: Improved surveillance is among the key research priorities identified for childhood TB, but progress to date has been slow.Recent advances in TB diagnostics, and standardized clinical diagnostic guidelines and case definitions, all provide opportunities for new strategies to improve surveillance.Better-quality data on the burden and trends of childhood TB will inform and improve both public health policy and clinical practice.

View Article: PubMed Central - PubMed

Affiliation: KEMRI-Wellcome Trust Research Programme, P.O. Box 230, Kilifi 80108, Kenya.

ABSTRACT
Tuberculosis (TB) is a leading cause of death globally. Natural history studies show that young children are at particularly high risk of progression to active TB and severe, disseminated disease following infection. Despite this, high-quality regional and global surveillance data on the burden of childhood TB are lacking. We discuss the unique aspects of TB in children that make diagnosis and therefore surveillance challenging; the limitations of available surveillance data; other data which provide insights into the true burden of childhood TB. Improved surveillance is among the key research priorities identified for childhood TB, but progress to date has been slow. Recent advances in TB diagnostics, and standardized clinical diagnostic guidelines and case definitions, all provide opportunities for new strategies to improve surveillance. Better-quality data on the burden and trends of childhood TB will inform and improve both public health policy and clinical practice.

No MeSH data available.


Related in: MedlinePlus