HUMAN MATTERS- TB: Children deserve special attention

Yesterday, March 24, was World Tuberculosis Day, commemorated by raising public awareness about the devastating health, social and economic consequences of TB, and boost efforts to end the global TB epidemic.

In marking the occasion this year, Health minister Ummy Mwalimu spoke at length on Saturday about why Tanzania must not relent in fighting the malady.

Noting that one TB patient who is not under medication can reportedly infect 10-to-20 other people with the bacterial disease each year, the minister lamented the abysmal lack of accurate data on TB, a lapse which is generally considered to be of great concern.

Try, indeed, to reconcile this fact with World Health Organisation (WHO) data showing that 70 people are infected with TB every day –and you will realise that the task ahead is still enormous.

To-date, Tanzania’s efforts to put TB patients under treatment haven’t reached the level where ALL infected citizens are actually captured and brought under treatment.

According WHO, about 154,000 Tanzanians get infected with TB each year. However, the government was only able to reach for treatment 75,845 infected persons in 2018, the minister revealed.

Admittedly, this is an improvement from the 62,180 people who were reached and treated in 2017.

In any case, it is commendable that the President John Magufuli government has surpassed the African Union (AU) Commission target requiring AU member states to reach and treat 74,200 TB patients a year.

But – as we heartily celebrate our efforts in terms of the AU requirements and World TB Day – it’s also important that we give special attention to children, one of the most TB-vulnerable groups of people.

Bearing in mind that an untreated TB patient can spread the bacteria to several others, suffice it here to say that children deserve keen attention – if only because, in many cases, adults are the source of TB to children.

The TB-causing Mycobacteria tuberculosis is transmitted through air – especially when an infected person coughs, sneezes, etc., thus releasing the bacteria into the air.

Children may breathe in the air droplets, thereby being infected. However, it must be understood that by simply inhaling the bacteria, the inhaler would necessarily develop symptoms of TB.

But, it must be made clear here that the risk of developing TB symptoms is higher in children than in adults. That’s why the plight of children calls for greater attention.

Most unfortunately, diagnosing TB among children is still a hard nut to crack. Firstly, for a child to be so diagnosed, it must cough out sputum which can be examined for the presence of the bacteria.

It is indeed a tough task for a medic to collect sputum from a year-old toddler. Getting sputum for further testing requires strictly adhering to appropriate instructions. Furthermore, children tend to swallow sputum instead of spitting it out.

There are special techniques to collect swallowed sputum from the stomach. But these require highly experienced healthcare workers.

Even after successfully collecting sputum, the nature of the disease among children is that it occurs with very low bacterial load, which may not meet the minimum number of bacteria that can be viewed under a microscope.

Also, TB in children quickly spreads to other parts of the body, outside the lungs. This means that a child can have the disease even without bacteria in its sputum. Children may also suffer a severe form of the disease, known as TB meningitis’, where bacteria affect the spine and brain.

There’s much more to this... Childhood TB constitutes 10 per cent of all tuberculosis notifications in Tanzania – more than half of whose diagnosis is based merely on symptoms and signs.

However, efforts are ongoing to devise better tools for diagnosing TB in children. But, the future of controlling childhood tuberculosis basically relies in the availability of simple, user-friendly tools.

We are here talking of how to use urine samples to test TB at ordinary dispensaries.

So, as we strive to track down those with TB and put them on treatment, let’s also think of how best to protect children from the malady as a matter of course.