Childhood Tuberculosis: Historical Perspectives, Recent Advances, and a Call to Action

Abstract

As the world focuses on the COVID-19 pandemic, it is important not to lose sight of other infectious and noninfectious diseases that continue to exact a major toll on the health of children. Childhood tuberculosis (TB) stands among the most serious of these, with an estimated 1.1 million cases of TB disease and more than 200,000 TB deaths in children less than 15 years of age in 2020 [1]. The COVID-19 pandemic has markedly decreased the global capacity to diagnose and treat TB in children and adults, resulting in decreased numbers of persons treated for TB in 2020, and the first increase in TB mortality in more than a decade [1]. Increased transmission from adults with untreated infectious TB is anticipated to reverse the previous slow but steady decline in TB in both children and adults. As global efforts to manage the COVID-19 pandemic continue, it is important to take stock of the state of childhood TB and evaluate what needs to be done, not just to reach the rate of progress that existed prior to the pandemic, but to advance efforts on multiple fronts to reduce morbidity and mortality from TB in children. In this series of articles, experts in childhood TB will address several aspects of the TB epidemic in children, including the interaction of TB with both HIV infection and with COVID-19, medication interactions and adherence, diagnostics, new treatments, systems and programmatic approaches to TB care and services, and vaccine development. These articles will identify the challenges in controlling childhood TB in 2022 and beyond, and highlight areas that can accelerate the prevention, diagnosis, and treatment of this longstanding global pandemic.