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Review
, 19 Suppl 1 (0 1), 9-16

Counting Children With Tuberculosis: Why Numbers Matter

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Review

Counting Children With Tuberculosis: Why Numbers Matter

J A Seddon et al. Int J Tuberc Lung Dis.

Abstract

In the last 5 years, childhood tuberculosis (TB) has received increasing attention from international organisations, national TB programmes and academics. For the first time, a number of different groups are developing techniques to estimate the burden of childhood TB. We review the challenges in diagnosing TB in children and the reasons why cases in children can go unreported. We discuss the importance of an accurate understanding of burden for identifying problems in programme delivery, targeting interventions, monitoring trends, setting targets, allocating resources appropriately and providing strong advocacy. We briefly review the estimates produced by new analytical methods, and outline the reasons for recent improvements in our understanding and potential future directions. We conclude that while innovation, collaboration and better data have improved our understanding of the childhood TB burden, it remains substantially incomplete.

Figures

Figure 1
Figure 1
The cascade from symptoms to reporting in children with tuberculosis
Figure 2
Figure 2
Improvements in age-disaggregated case reporting between 1990 and 2012
Figure 3
Figure 3. Methodology employed by the World Health Organization to estimate the incidence of tuberculosis in children
TB: tuberculosis; WHO: World Health Organization
Figure 4
Figure 4. Methodology employed by Jenkins et al. in the estimation of tuberculosis in children
TB: tuberculosis
Figure 5
Figure 5. Methodology employed by Dodd et al. in the estimation of tuberculosis in children
TB: tuberculosis; ARI: annual risk of infection; HIV: human immunodeficiency virus; BCG: Bacillus Calmette–Guérin; EPTB: extra-pulmonary tuberculosis; PTB: pulmonary tuberculosis

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