COVID-19:Must not divert attention from needs of TB children in Africa

16May 2020
The Guardian
COVID-19:Must not divert attention from needs of TB children in Africa

Tuberculosis is caused by bacteria that most often affect the lungs. TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.

TB is one of the top 10 causes of death and the leading cause from a single infectious agent above HIV/AIDS.

A total of 1.5 million people died from TB in 2018 including 251 000 people with HIV worldwide. In 2018, 1.1 million children fell ill with TB globally, and there were 205, 000 child deaths due to TB including among children with HIV.

The International Union Against Tuberculosis (IUAT)

has warned that if resources are diverted away from child and adolescent tuberculosis programmes in order to fight COVID-19, the consequences for the estimated 400,000 children and adolescents in the African region needing TB and multidrug-resistant TB care each year could be devastating.

As the coronavirus pandemic makes its way into the African continent, there are concerns about its potential impact on the large number of children and adolescents living with TB infection or disease across the region. TB is both curable and preventable but remains a major cause of morbidity and mortality in children and adolescents and has only recently been afforded the attention that was long overdue.

“There is clear overlap in the public health response required to confront the coronavirus pandemic with what is already required for TB – case detection, contact screening and management, and infection control”, said Dr Grania Brigden, Director of The Union’s TB Department. “This provides an important opportunity to integrate rather than disperse health services. The needs of children and adolescents should be considered when developing alternative methods for screening, referral and medication delivery as countries determine how to shift routine service delivery to minimise contacts in health facilities”

An estimated one million children fall ill with TB every year, and one-quarter of all people with TB disease in the world live in Africa. In 2018, of all the people living with HIV in the world who developed TB, 72 per cent of them were in Africa. And sub-Saharan Africa accounted for 82 per cent of all HIV-associated TB deaths that same year.

It is very true that evidence to date would suggest that children and adolescents (0-19 years) are less susceptible than adults to severe COVID-19, the disease caused by SARS-CoV-2. Indeed, the numbers of TB-related deaths in children and adolescents globally in 2020 - around a quarter of a million – will far exceed those due to COVID-19.

We also share the concerns about the impact of COVID-19 on recent efforts to scale up TB preventive therapy, particularly in young child contacts (less than five years) or children and adolescents living with HIV.  Efforts to secure supply chains of needed medical equipment, laboratory commodities and medications for this vulnerable population will be critical to averting negative impacts.

We appreciate the Union’s call on donors and partners to continue to support TB care and prevention responses – including a focused effort on child and adolescent TB. The Union is also calling on national TB programmes and ministries of health to keep TB and comorbidities on the agenda during the COVID-19 response.

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