Action must be taken to prevent the “unnecessary” deaths of nearly a quarter of a million children - most aged under five - from tuberculosis, researchers say.
New modelling by a team including University of Sheffield’s School of Health and Related Research estimates 239,000 children aged 14 years and under died from TB worldwide in 2015.
For the first time it has revealed an estimate that 191,000 of the children, were aged under five.
Nearly all the deaths were in children who were not receiving treatment, and nearly one in five also had HIV.
Lead author Pete Dodd from the University of Sheffield, said he hoped the findings would “motivate and energise” agencies to take novel approaches to finding and treating children with TB.
Mr Dodd said: “We estimate 239,000 children died from TB in 217 countries in 2015 – 80 per cent were under five years of age.
“The study is the first time someone has actually produced the number of deaths due to TB in the under-fives.
“It makes TB a top ten cause of death in this age group, causing more deaths than meningitis, AIDS, measles and whooping cough.
“This really is a call to action - the majority of these deaths should be preventable. When children are diagnosed and receive appropriate treatment, almost all survive.
“We need to do a better job of identifying children with TB and put them onto treatment and giving them preventative therapy to stop them developing the disease in the first place.”
India, Nigeria, China, Indonesia and the Democratic Republic of the Congo had the highest death tolls for the “preventable and treatable” disease.
TB is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person.
It can usually be treated with a course of antibiotics which is taken for six months.
Historically childhood tuberculosis has often been overlooked as it can be difficult to diagnose.
Tests are not sensitive enough and symptoms can be non-specific.
The under-fives are also more prone to developing the most severe form of the disease, disseminated tubrculosis, where the bacteria have spread from the lungs to other parts of the body and TB meningitis, a life-threatening condition where TB causes inflammation of the membranes that surround the brain and the spinal cord.
Researchers from Boston University, Brigham and Women’s Hospital and Harvard Medical School in the United States, Imperial College, London, and the World Health Organization also contributed to the study.
Co-author Helen Jenkins, Assistant Professor at Boston University School of Public Health, said: “Tuberculosis is preventable and treatable and we must do more to stop these unnecessary deaths in children”.
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.
These estimates have been important in assessing progress towards targets, directing public health funding and spending, and for advocacy.
However, tuberculosis has never before been explicitly included in these estimates.