Summary
Globally, an estimated 1·2 million cases of tuberculosis disease each year occur in children younger than 15 years, and around 67 million children have tuberculosis infection, putting them at the risk of developing tuberculosis disease.
Tuberculosis in childhood was historically neglected in surveillance efforts, with national tuberculosis programmes focusing primarily on cases of microscopically smear-positive tuberculosis, which is more common among older adolescents or adults. The diagnosis of tuberculosis in children is made challenging by low suspicion among health-care providers, reliance on sputum microscopy, which has very low sensitivity (ranging from 1–14%), children’s difficulty in producing sputum, or disease with low bacillary load.
In The Lancet Global Health, Lasith Ranasinghe and colleagues provide a retrospective analysis of childhood tuberculosis notifications and how the number of notifications changed in 2020 during the COVID-19 pandemic.
The authors primarily focus on the 30 countries with high tuberculosis burden, using time-series prediction modelling to quantify the effect of the COVID-19 pandemic on observed tuberculosis notifications compared with the predicted number. This study offers an overview of regional trends in notifications before and during the COVID-19 pandemic. 24 of the 30 countries with high tuberculosis burden showed a decrease in tuberculosis notifications among children aged 0–4 years, and the global mean decrease in notifications in this age group was 35·4% (95% PI –30·3 to –39·9). These results can inform the allocation and management of human, technological, and financial resources for childhood tuberculosis care. The study also examines sex differences in childhood tuberculosis across all WHO regions, showing that substantially more boys aged 0–4 years than girls were notified annually from 2014 to 2020 read more…
