The number of children with TB could be much higher than currently believed, researchers warn today.
More than 500,000 children are known to be infected with the disease – but researchers say it could be 25% more than this.
Dr Peter Dodd, from Sheffield University, UK, and his team looked at tuberculosis rates in children using mathematical modelling of household details and population structure in different countries, plus TB rates in adults.
Usually, estimates are based on reported cases, but the researchers say this is unreliable and varies widely between countries.
Their findings suggest that about 7.6 million children (aged below 15) in the 22 TB "High Burden Countries", or HBCs, became infected with Mycobacterium tuberculosis in 2010. Of those infected, about 650,000 developed TB. The highest burden of childhood TB by far is in India.
Dr Dodd and the team say that about 65% of active TB cases in children are missed by national TB programmes, more than those missed in adults.
Their estimates indicate that the rate in children could be almost 25% higher than figures from the World Health Organisation, which identified some 530,000 cases in 2012.
Details are published in The Lancet Global Health today.
"Our findings highlight an enormous opportunity for preventive antibiotic treatment among the 15 million children younger than 15 years of age who are living in the same household as an adult with infectious TB," says Dr Dodd.
"Wider use of isoniazid therapy for these children as a preventative measure would probably substantially reduce the numbers of children who go on to develop the disease."
He added: "Quantifying the burden of TB in children is important because without good numbers, there can be no targets for improvement, no monitoring of trends and there is a lack of evidence to encourage industry to invest in developing medicines or diagnostics that are more appropriate for children than those available today."
Dodd, P. J. et al. Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. The Lancet Global Health 9 July 2014 doi: 10.1016/S2214-109X(14)70245-1 [abstract]
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