Staff Reporter :
Children aged zero to five are more vulnerable to Tuberculosis (TB). The disease may not be detected even by sputum test. So the number of child tuberculosis patient is on the rise in the country.
According to statistics of the TB Control Programme of BRAC, the number of TB affected children was 1,625 in 2005, 4,184 in 2006, 4,044 in 2007, 4,052 in 2008, 4,581 in 2009, 4235 in 2010, 4,667 in 2011, 4,833 in 2012, 5044 in 2013 and 6318 in 2014.
Experts identified detection is the most challenging job as children cannot produce cough that is required for diagnosis. Besides, there are other technical and social reasons such as lack of diagnosis and treatment facilities, malnutrition, lack of awareness, orientation of the physicians, the absence of training and guidelines for health workers.
The Centre for Woman and Child Health in 2011 identified that the country lacked ‘family centered contact tracing’ which involves testing family members of an infected patient.
According to the Centre for Disease Control and Prevention, TB disease in children under 15 years (also called paediatric tuberculosis) is a public health problem of special significance because it is a marker for recent transmission of TB.
According to NTCP data, there were 0.18 million TB patients detected under the programme. The rate of detection is 119 per 0.1 million and the number of child TB patients is only 5,044 which is 3.0 per cent of total TB patients. The high ups in the government claim the percentage to be 6.0. Experts think the number of child TB patients is much higher in the country. This is still far below the WHO’s estimation that in Bangladesh TB to children under 15 years of age is 10 percent of the total detected cases.
National TB Control Programme line director M Ahmed Hussain Khan told that the number is increasing as most pediatricians are not trained in TB.
‘Pediatricians treat tuberculosis patients for pneumonia and other diseases with similar symptoms to TB,’ he said.
“Doctors never took it (TB) seriously in their diagnostic consideration,” he added.
He said “They used to diagnose their (children) symptoms as lung infections and other respiratory problems. But they rarely thought kids can suffer from different types of TB from lung to bone”.
Due to lack of orientation, physicians sometimes misdiagnose or often get confused with child patients when they are attacked overlapping the symptoms with pneumonia or acute respiratory infections, he added.
Even physicians also make misinterpretation of X-ray reports done for detecting specific TB, he said, adding that lack of awareness about TB makes children extremely vulnerable to the disease as they can get infected by adult TB patients inside or outside the family.
“Children cannot give cough for testing,” pulmonologist Dr Asif Mujtaba Mahmud told as TB programme was focused on cough testing.
“Now we do x-ray instead of taking cough and Mantoux test (a kind of test on skin),” he said.
He, however, said child TB detection was neglected across the world. “It’s not difficult to detect them. But it came into focus across the world only recently”.
Besides Bangladesh does not have enough equipment, including the GeneXpert machine needed to identify TB, he added. At least 224 people for every lakh are newly affected with TB every year, while 402 out of every lakh are infected by TB at any point of time.
At least 51 people died last year from TB while 1,91, 155 people were identified as TB patients. But there are many undetected TB patients. There is confusion about the number of TB and child TB patients.
Although Bangladesh has achieved remarkable success in eradicating tuberculosis from the country through the directly observed treatment short-course (DOTS) strategy since 1993, the child TB is still a problem in our country.
For this why, BRAC is working with the Government through DOTS to control child TB across the country.
Sources said, BRAC’s shasthyashebikas (frontline community health worker) play a pivotal role in connecting individuals with TB control services during household visits and health forums. They disseminate TB-specific messages to the community, identify child TB patients and refer them, for sputum examination, to the government sub-district health complex or peripheral laboratories of BRAC.
Children aged zero to five are more vulnerable to Tuberculosis (TB). The disease may not be detected even by sputum test. So the number of child tuberculosis patient is on the rise in the country.
According to statistics of the TB Control Programme of BRAC, the number of TB affected children was 1,625 in 2005, 4,184 in 2006, 4,044 in 2007, 4,052 in 2008, 4,581 in 2009, 4235 in 2010, 4,667 in 2011, 4,833 in 2012, 5044 in 2013 and 6318 in 2014.
Experts identified detection is the most challenging job as children cannot produce cough that is required for diagnosis. Besides, there are other technical and social reasons such as lack of diagnosis and treatment facilities, malnutrition, lack of awareness, orientation of the physicians, the absence of training and guidelines for health workers.
The Centre for Woman and Child Health in 2011 identified that the country lacked ‘family centered contact tracing’ which involves testing family members of an infected patient.
According to the Centre for Disease Control and Prevention, TB disease in children under 15 years (also called paediatric tuberculosis) is a public health problem of special significance because it is a marker for recent transmission of TB.
According to NTCP data, there were 0.18 million TB patients detected under the programme. The rate of detection is 119 per 0.1 million and the number of child TB patients is only 5,044 which is 3.0 per cent of total TB patients. The high ups in the government claim the percentage to be 6.0. Experts think the number of child TB patients is much higher in the country. This is still far below the WHO’s estimation that in Bangladesh TB to children under 15 years of age is 10 percent of the total detected cases.
National TB Control Programme line director M Ahmed Hussain Khan told that the number is increasing as most pediatricians are not trained in TB.
‘Pediatricians treat tuberculosis patients for pneumonia and other diseases with similar symptoms to TB,’ he said.
“Doctors never took it (TB) seriously in their diagnostic consideration,” he added.
He said “They used to diagnose their (children) symptoms as lung infections and other respiratory problems. But they rarely thought kids can suffer from different types of TB from lung to bone”.
Due to lack of orientation, physicians sometimes misdiagnose or often get confused with child patients when they are attacked overlapping the symptoms with pneumonia or acute respiratory infections, he added.
Even physicians also make misinterpretation of X-ray reports done for detecting specific TB, he said, adding that lack of awareness about TB makes children extremely vulnerable to the disease as they can get infected by adult TB patients inside or outside the family.
“Children cannot give cough for testing,” pulmonologist Dr Asif Mujtaba Mahmud told as TB programme was focused on cough testing.
“Now we do x-ray instead of taking cough and Mantoux test (a kind of test on skin),” he said.
He, however, said child TB detection was neglected across the world. “It’s not difficult to detect them. But it came into focus across the world only recently”.
Besides Bangladesh does not have enough equipment, including the GeneXpert machine needed to identify TB, he added. At least 224 people for every lakh are newly affected with TB every year, while 402 out of every lakh are infected by TB at any point of time.
At least 51 people died last year from TB while 1,91, 155 people were identified as TB patients. But there are many undetected TB patients. There is confusion about the number of TB and child TB patients.
Although Bangladesh has achieved remarkable success in eradicating tuberculosis from the country through the directly observed treatment short-course (DOTS) strategy since 1993, the child TB is still a problem in our country.
For this why, BRAC is working with the Government through DOTS to control child TB across the country.
Sources said, BRAC’s shasthyashebikas (frontline community health worker) play a pivotal role in connecting individuals with TB control services during household visits and health forums. They disseminate TB-specific messages to the community, identify child TB patients and refer them, for sputum examination, to the government sub-district health complex or peripheral laboratories of BRAC.
