Did you know the global burden of tuberculosis (TB) among children has dropped significantly over the past three decades? A recently published article analyses the global tuberculosis burden children face. It details the situation from 1990 to 2021 using data from the Global Burden of Disease Study 2021. The report shows a significant decrease in TB incidence, mortality, and disability-adjusted life years (DALYs) over this period. However, regional and socioeconomic disparities remain notable. Despite progress, tuberculosis continues to pose a major public health threat, especially in areas with a low socio-demographic index (SDI).

Key Insights

• Decline in TB Burden: The global TB incidence among children and adolescents decreased by 37.4% from 1990 to 2021. Deaths also dropped by 71.7%.
• Regional Disparities: Regions with low SDI, such as parts of Africa, still face a high tuberculosis burden in children disproportionately. High-income regions, however, have seen substantial reductions.
• Sex Differences: Females under 20 have higher age-standardised incidence rates (ASIR), mortality rates (ASMR), and DALY rates compared to males.
• Drug Resistance: Multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) among children and adolescents are growing concerns.

Background Context

The World Health Organization (WHO) is working to end TB through its End TB Strategy. This strategy aims to reduce TB incidence and mortality by defined targets. Progress has been slow, especially in children and adolescents, where TB remains a major cause of morbidity and mortality. The COVID-19 pandemic has further complicated TB control efforts. It disrupted healthcare services and led to underreporting of TB cases. For detailed analysis, see here.

Implications

The findings have important implications for health economics and outcomes research:

• Healthcare Infrastructure: Investing in healthcare infrastructure, especially in low SDI regions, is crucial for improving TB diagnosis and treatment.
• Socioeconomic Interventions: Addressing factors like poverty and malnutrition can help reduce TB transmission.
• Drug Resistance Management: Effective strategies are needed to manage drug-resistant TB and prevent its spread among vulnerable populations.
• Research and Development: More research into pediatric TB diagnostic tools and treatment formulations is urgently needed to improve outcomes for children and adolescents.