Two million children now infected by drug resistant TB say Sheffield researchers

Tuberculosis (TB) in children is increasingly being recognised as a significant public health issue, and now academics from Sheffield University have been involved in a new research project to measure the extent of the problem worldwide.

The study estimates that at least 67 million children were infected by Mycobacterium tuberculosis with 850,000 developing the active disease.

And of these children, two million youngsters were estimated to be infected with multi-drug-resistant (MDR) tuberculosis strains. This is said to be leading to be to 25,000 cases of MDR-TB disease requiring expensive and toxic treatment.

The report, published today in The Lancet Infectious Diseases, warns that the identified cases of drug-resistant TB in children are the tip of the iceberg.

It also says there is a large unmet need for diagnosis, drug-susceptibility testing, and appropriate treatment.

TB in children is increasingly being recognised as a significant public health problem, and an important element of the total global burden of the disease, the university’s academics claimed.

The new figures were compiled as a result of “innovative modelling and statistical analysis” carried out by researchers from Sheffield University as well a from Imperial College London, and the World Health Organisation.

Peter Dodd, an infectious disease epidemiologist from the University’s School of Health and Related Research (ScHARR), said: “Our report shows far more drug-resistant TB occurs in children than is diagnosed, and there is a large pool of drug-resistant infection.

“If they are not identified as having drug-resistant TB, children are unlikely to receive appropriate and effective treatment.

“After infection with Mycobacterium tuberculosis, young children are at particularly high risk of progressing to tuberculosis disease.

“They are also more likely to develop more severe forms of disease such as TB meningitis and disseminated TB.”

Improving the estimates of the rates of drug resistance in children are important because paediatric tuberculosis can be more difficult to diagnose.

It is also said to be more challenging to test for drug sensitivity, and more likely to cause extra-pulmonary infection.

Africa and South-East Asia were found to have the highest numbers of children with TB.

However, the World Health Organisation said the Eastern Mediterranean region, European region, and Western Pacific region also contribute substantially to the burden of drug-resistant TB because of their much higher proportions of resistance.

The findings could have implications for approaches to treatment and preventive therapy in some parts of the world.

• YORKSHIRE UNIVERSITIES are at the forefront of research into tuberculosis and how health systems can improve to cope with its impact.

York University is involved in a four-year programme looking into how the stress placed on healthcare systems around the world, by tobacco and TB, can be reduced. The European Commission-funded project will see a team from the university’s Department of Health Sciences and Hull York Medical School explore ways to integrate interventions to stop smoking into TB control programmes.

The university has secured more than £2m from the European Commission’s Horizon 2020 fund.