Children are Unknown Victims in Global TB Response

It is estimated that at least one million tuberculosis (TB) cases occur each year among children, and most of them in developing countries. These are conservative estimates because many children with TB are not notified, and many others live without access to proper diagnosis or treatment. This makes it difficult to calculate the true number of children affected by the disease. 

Childhood TB has not received the attention it deserves in the global TB response. The real tragedy is that children have been largely neglected in research, epidemiology and surveillance. “Children who are exposed to TB include those from poorer families, those in close contact with TB patients--especially infected relatives, malnourished children, and children living in overcrowded conditions. We lack the proper mechanisms to really help these infants and children.” says Zari Gill, World Vision’s director of infectious disease.

World Vision has specifically been working to draw attention to the impact of TB on children and to raise awareness in communities of the signs and potential effects of TB in children. Staff also work to strengthen local health systems to increase access to diagnosis and treatment, and to help communities monitor their TB patients to assure they complete their full course of TB treatment.

In its community-based response, World Vision trains local volunteers to conduct directly observed treatment short-course (DOTS) for TB treatment to help increase community knowledge about TB transmission, prevention and treatment. Training community volunteers contributes to the capacity of the local health system, freeing health staff time to focus on diagnosis and contact tracing, which is instrumental in the fight against TB. Contact tracing enables the community to identify where a person infected with TB contracted the disease, seeking to treat the disease at the source to prevent re-infection as well as further spread of the disease.

Globally, World Vision joins other organisations in its fight against TB. World Vision partners with the Stop TB Partnership and TB REACH. The TB REACH initiative of the Stop TB Partnership has a fast-track competitive selection of innovative projects, rapid disbursement of funds and a robust monitoring and evaluation system. TB REACH offers a lifeline by finding and treating people in the poorest, most vulnerable communities in the world. In areas with limited or nonexistent TB care, TB REACH supports innovative and effective techniques to find people with TB quickly, avert deaths, stop TB from spreading, and halt the development of drug-resistant strains. 

One of the newest projects funded by TB REACH is in Rwanda, where the World Vision team has launched the TB project on a national scale. In the first four months of the project in Rwanda, World Vision has helped to identify 154 new TB cases in adults and children, educated more than 1500 youth, obtained extensive media coverage, trained and equipped community health workers in three districts, and provided eight microscopes to local health facilities—necessary equipment for TB case detection.

Esperance Akayezu is a 24-year-old mother of two who was helped through this TB response project. Just six months ago Esperance believed dying was better than living. Since then, with the help of WV Rwanda’s tuberculosis (TB) response project, she has received diagnosis and treatment for her TB, as well as other assistance. She no longer despairs of life.

Esperance lives in a mud house with her pregnant sister and her two children, Uwase Divine and Ishimwe Prince, who are being treated for malnutrition. The entire family lives on sparse wages earned by local farm work. She has struggled to raise her two children in these circumstances, and her TB disease has put her children at risk of infection.

Esperance retells her first encounter with World Vision’s TB programme: “A few months ago, a community health worker who works with World Vision invited me to a TB screening. The next day, I went with her for screening. My results showed I was positive for TB, but, fortunately, HIV-negative. I was shocked and really needed some extra support.”

Since receiving help, Esperance is healthier and her children are protected from becoming infected with TB by their mother. Through community health workers trained by World Vision, Esperance receives regular home visits and medication. World Vision also assists with porridge, vegetable seeds and rabbits for her kitchen garden. She has gained 13 kilograms thanks to better nutrition.

“I thank World Vision and local health centre staff because they have advised me on several issues and provide counselling whenever I need it,” she said.

Thanks to generous sponsors, all TB patients have been supported through community-based DOTS, as well as small income generating activities such as small livestock (pigs, goats, rabbits). They also receive vegetable seeds and training about HIV and nutrition -- conducted especially for prevention and management of TB.

Read World Vision’s Call to Action to Prevent Childhood TB.