In South Africa, which has the third highest level of TB in the world, children are particularly vulnerable to catching the illness from infected adults in their families. The number of children with TB, particularly in areas where the disease is endemic, is therefore thought to be extremely high. Some estimates suggest as many as 15-20% of children could carry the disease in certain regions of the country.
A new article by IRIN looks at the problem and how for a long time specialist research into children with TB has been neglected. Speaking to the news agency, the Director of the Paediatric TB Research Programme at the Desmond Tutu TB Centre at Stellenbosch University in the Western Cape Province, explains that until around ten years ago, there was little money available for research into childhood TB. This is needed because paediatric TB differs in a number of ways from the adult illness, making it tricky to confirm a diagnosis and provide the right treatment. For example, children are usually infected with far fewer organisms, making detection in a sample of sputum much harder. Traditional TB medications also take effect in a different way in children. Studies now suggest children may even need higher doses of certain drugs than adults.
HIV-positive children and infants are especially vulnerable to catching TB, which is of great concern, since TB is the leading killer of HIV-positive people globally. The combination of HIV/AIDS and TB makes working out the right drug regime even harder. And as the Paediatric Director notes, many medicines come in adult doses, where tablets have be broken up and crushed, making it tricky to get the right amount of medication for a child. Through the new research, experts hope to work on improving child-specific methods of treatment and dosages.
While further research is badly required, health experts in South Africa also highlight the need to raise awareness of the disease generally. Children with TB often complain of headaches and display symptoms such as persistent coughing, vomiting or lack of appetite. Doctors and parents in South Africa are being urged to look out for these telltale signs, as well as for children complaining of constant tiredness. With early identification, TB can be successfully treated, but first, carers have to be aware that something is wrong.