By Winniecynthia Awuor
The Africa Union and the World Health Organization (WHO) have called for immediate and comprehensive measures to end the significant toll of tuberculosis (TB) among children in the African region.
This appeal was made jointly with Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and stop TB Partnership at the side-lines of the 72nd session of the WHO Regional Committee for Africa in Lome, Togo.
“The widespread tuberculosis among children in Africa has been occurring in the shadows and has until now been largely ignored. We hope this call will galvanize action and ensure no child in Africa is lost to a disease which in many parts of the world is now history,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.
Africa is home to 17 out of 30 countries with the highest tuberculosis burden globally, accounting for around 322 000 children and young adolescents (aged 0-15 years) and a third of tuberculosis cases among those under 15 years worldwide.
Among all these cases, two-thirds are not reported or diagnosed leading to an increased risk of rapid disease progression and death, especially in younger children making only a third which is around 32% diagnosis- the smallest proportion globally.
The low detection of tuberculosis arises from challenges in specimen collection as well as bacteriological confirmation of the disease among children who can display non-specific clinical symptoms that overlap those of other common childhood diseases.
Additionally, children and young adolescents usually access primary health care or child health services in facilities where the capacity to diagnose for tuberculosis is often limited.
“One child dies of tuberculosis somewhere in the world every two minutes even though tuberculosis is curable and preventable. Children with tuberculosis are almost never spreading the disease and are always infected by an adult, so their suffering is a metric of our failures to diagnose and treat tuberculosis in children,” said Dr Lucica Ditiu, Executive Director of Stop TB Parnership.
Worsening the impact of tuberculosis is malnutrition. Globally, 19% of all tuberculosis cases are associated with malnutrition.
“Childhood tuberculosis doubled with malnutrition poses major health challenges in the African Union Member States,” said Minata Samate Cessouma, Commissioner for Health, Humanitarian Affairs and Social Development, African Union Commission.
Samate further noted that, undernourished children with tuberculosis are susceptible to developing extensive and severe complications. Therefore there is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programmes to identify the disease in children quickly.
Elsewhere, Under the WHO End TB Strategy, countries should aim to reduce TB cases by 80% and cut deaths by 90% by 2030 compared to 2015. The strategy also sets key milestones that countries should cross by 2020 and 2025 if they are to end the disease.
The 2020 milestone sought a 35% reduction in TB deaths and 20% decline in cases. Only six countries with high tuberculosis burden met the 2020 case reduction milestone and just six achieved the target to reduce deaths by 35%.
“Strong political leadership, accountability, financial support and global solidarity are critically needed to increase access to effective diagnostics, medications, vaccines and other tools for tuberculosis control,” said Dr. Moeti.
Currently, investment and funding for tuberculosis control in Africa remains low, jeopardizing the efforts to meet the global target of ending the disease by 2030.
The African region requires at least US$ 1.3 billion for tuberculosis prevention and treatment every year, yet countries contribute 22% of the needed budget while external funding accounts for 34%. The rest of the budget remains unfunded.