A new finding suggests that there is a high risk of TB infection and disease in children up to 10 years old who live in areas where TB spread is common.
A study conducted in South Africa found that children living in areas where tuberculosis (TB) transmission is common have a high risk of TB infection and disease, with up to 10% developing the disease by age 10, published in The Lancet Child & Adolescent Health.
Around 1.2 million children globally develop TB disease every year, and roughly 200,000 die from it, few studies have investigated the risk of developing TB during childhood, particularly in high-burden countries like South Africa. Approximately 15% to 20% of all TB cases in South Africa, which has one of the highest TB incidence rates in the world, are likely to occur in children.
A new study led by Boston University School of Public Health, the University of São Paulo, and the University of Cape Town sheds new light on this risk, with finding that there is a high risk of TB infection and disease in children up to 10 years old who live in areas where TB spread is common.
For the study, researchers from the Boston University School of Public Health (BUSPH), the University of Cape Town, and the University of Sao Paulo followed 1,137 women and their 1,143 children who were living near Cape Town between 2012 and 2023 and were enrolled in the Drakenstein Child Health Study. They tested the children for TB infection and disease at age 6 months, 12 months, and then annually for those who produce negative test results, as well as whenever they developed lower respiratory tract infection.
The team estimated that children faced a 36 percent cumulative risk of TB infection by age 8. New cases of TB disease were highest during the first year of life, and decreased gradually as children grew older. 1 in 10 children afflicted by TB disease by age 10 is still an alarming finding because it signals potential long-term health consequences, including weakened immunity.
“These results are striking and show that children in these communities in South Africa are at extraordinarily high risk,” says study co-senior author Leonardo Martinez, an assistant professor of epidemiology at BUSPH. “It’s clearly an urgent health problem with both short and long-term impacts on these children and their families.”
Co-senior author Dr Heather Zar noted that many TB cases in children were diagnosed when they presented with acute pneumonia, suggesting that pneumonia cases in high TB-prevalence areas should be checked for TB as well.
As part of its Sustainable Development Goals, the World Health Organization (WTO) has pledged to reduce TB incidence by 80 percent and TB deaths by 90 percent by 2030.
Dr. Martinez believes tackling pediatric TB epidemic in South Africa and other high-burden nations requires a comprehensive solutions, which needed a multi-sectoral approach that brings together stakeholders globally.
