Tuberculosis (TB) is thought to have affected more than one million children under 15 worldwide in 2015. Diagnosis of TB in children can be challenging, partly due to insensitive tests and non-specific symptoms.
Although younger children are vulnerable to more severe forms of the disease, there are currently no estimates of the mortality rate for under-fives.
"We estimate 239,000 children aged 14 years and under died from TB in 217 countries in 2015. 80 per cent of these were children under five years of age. This makes TB one of the top 10 causes of death in the age group," said Pete Dodd from the University of Sheffield in the UK.
Most deaths were in the Africa and southeast Asia regions, both for chilren under 5 and 15. The highest mortality was found in India, Nigeria, China, Indonesia, and the Democratic Republic of the Congo.
All these countries are on the current WHO list of 30 high tuberculosis burden countries; all are populous, with tuberculosis incidence rates under 400 per 100,000 per year, researchers said.
"Historically, TB in children has not received the attention that it might have done. The World Health Organization has been encouraging countries to report the number of TB cases they find in children by age group," Dodd said.
Under-five mortality was a key indicator in the Millennium Development Goals and the subsequent Sustainable Development Goals, and is tracked by the UN Inter-agency Group on Child Mortality Estimation (IGME).
These estimates have been important in assessing progress towards targets, directing public health funding and spending, and for advocacy.
However, tuberculosis has never been explicitly included in these estimates.
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