ENDING TUBERCULOSIS IN CHILDRENQUICK FACTS

KEY CHALLENGES TB illness in children is often missed oroverlooked due to non-specific symptoms andlack of a sensitive and child-friendly diagnostic
test (not based on sputum).
 Health workers in TB programmes and other
health services often lack sufficient knowledge
and capacity for prevention, diagnosis andmanagement of childhood TB.
 Systematic screening for TB and isoniazid
preventive therapy (IPT) for children under 5years of age and children living with HIV are
rarely implemented or reported.
 Lack of community knowledge and engagement.
 Until recently, no child-friendly formulations
were available and there are no childformulations of second line TB drugs.
 The current TB vaccine (BCG) protects young
children against the most severe forms of TB,
but does not prevent the transmission of TB froman infectious contact.

At least 1 million children fall ill with tuberculosis(TB) each year. Children represent about 11% of
all TB cases.*
In 2015, 210,000 children died of TB, including
40,000 TB deaths among children who were HIVpositive.*
Researchers estimate that 67 million children areinfected with TB (latent TB) and are therefore at
risk of developing disease in the future.**Researchers estimate that 25,000 children
develop multidrug-resistant TB every year. *** Global TB Report 2016 ; ** Dodd et al., 2016

RISK FACTORS Any child living in a setting where there are people
with infectious TB can become ill with TB, even if
they are vaccinated.
 Children with vulnerable immune systems, such as
the very young, HIV-infected or severely
malnourished, are most at risk for falling ill or
dying from TB. Risks are very high for HIV-infectedmothers and children.
 Infants and young children are at increased risk ofdeveloping severe disseminated disease associatedwith high mortality, such as TB meningitis or
miliary TB.
 Adolescents are at particular risk of developing
adult type disease, i.e. often sputum smearpositive and highly infectious.
 Children with TB are often poor and live in
vulnerable communities where there may be a lackof access to health care.
 Children develop TB disease usually within 1 year
following infection. TB in children is an indicator ofrecent and ongoing transmission of M.tuberculosis
in the community.
 Children with a known contact with drug-resistant
TB are at high risk of developing drug-resistant TB.

For more information please visit:
http://www.who.int/tb/areas-of-work/children/en/© World Health Organization 2016

CHILDHOOD TB ROADMAP:TOWARDS ZERO DEATHS
A first-ever targeted andcosted roadmap with key
steps to scale up the responseto childhood TB and end
childhood TB deaths waslaunched by WHO andpartners on 1 October 2013 inWashington DC, USA.
The Roadmap set targets for 2020 and 2025 andlisted immediate actions to be taken. The goal ofreaching zero TB deaths in children as outlined in
the Roadmap is within our grasp. Achieving thisrequires sustained advocacy, greater commitment,
mobilization of increased resources and a joint
effort by all stakeholders involved in providing
health care for children and in TB control. It requires
intensified action to get existing tools in the handsof frontline health workers, cross-sectoralcollaboration and increased investment in researchfor new tools.

CHILDHOOD TB ROADMAP: PROGRESSON KEY ACTIONSCHILDHOOD TB – A PRIORITY IN
THE GLOBAL HEALTH AGENDA
 Ending TB by 2030 is a target of the United Nations
Sustainable Development Goals (SDGs) and the
WHO End TB Strategy. Actions to address childhood
TB are a key component of both the Strategy and theSDGs to reach this target.
 Under the child survival movement’s banner of A
Promise Renewed, more than 180 countries signed apledge in June 2012, vowing to redouble efforts tostop children from dying of preventable diseases,
including TB.
 In 2015, Global Partners launched a renewed Call toAction to End Childhood TB.

PROGRESS IN COUNTRIESHigh profile of childhood TB at all levels
 Regional
stakeholders
meetings
withrepresentatives of national TB and MCH
programmes, as well as national paediatricsocieties from high burden countries.
 Regional Childhood TB Task Forces established inAfrica, the Americas, Europe and the Western
Pacific regions.
 Childhood TB included in national TB plans Increased funding (e.g. from the Global Fund,
USAID and UNITAID) to scale up the response tochildhood TB.
Improved recording and reporting of data
• In 2015, 200 countries reported data
disaggregated by sex and age .
 Burden and mortality estimates have improved
overall including for childhood TB. Inventory
studies will further refine disease burden andmortality estimates.
Training and reference materials to build andstrengthen capacity of health workers
 WHO Guidance for National TB Programmes on
the Management of TB in Children The Union and WHO childhood TB training
materials, including an online interactive coursefor health workers.
 Assessment tools developed by WHO and theKNCV Tuberculosis Foundation.
Address research gaps
• In December 2015, the TB Alliance, WHO andglobal partners launched child-friendly TB FixedDose Combinations.
 Children are now part of clinical trials but more
efforts are needed to develop accurate diagnostic
tests, child-friendly shorter regimens as well as
formulations of second-line drugs, and better
vaccines.

Tajikistan–intensified contact tracing
and active case finding at Primary HealthCare level and reduced hospitalization

Ethiopia – national
Childhood TB Roadmap

Map illustrates
distribution of newand relapse TB cases
who were children(>15), 2015

Uganda - national Childhood TB Guidelines
and training of health workers

Bangladesh –updated childhood
TB guidelines andtraining of doctors
and health careworkers

Vietnam – scale up
of contact-based
screening andprovision of IPT

Kenya –early
implementer ofchild TB fixed-dose
combinations