International meeting on eliminating childhood tuberculosis

Children suffer severe tuberculosis (TB) related illness that contributes to the overall burden of TB and potentially to overall child mortality. Worldwide, about 1 million TB cases occur each year in children (under 15 years of age) (1).

The latest data from the entire WHO European Region shows that more than 12.6 thousand (8 per 100 000 population) new TB cases occur annually among children. More than 85 % of them were reported by the 18 high priority countries to Stop TB in the Region (3). Rates in those countries were more than six times higher than in the rest of the Region, 14.25 and 2.32 per 100 000 population respectively. However, it is considered that TB in children is underdetected because of the difficulty in diagnosing the disease and/or possible underreporting.

In spite of the overall decline of TB notification rates in the last decade, three thousand children developed TB in the countries of the European Union and European Economic Area in 2010, which remains a marker of transmission in the community, with paediatric cases increasing in the low-burden countries over the past 10 years.

Treatment of TB in children is challenging due to lack of readily available paediatric and child-friendly formulations of anti-TB drugs and difficulty in treating severe forms of TB such as TB meningitis and disseminated TB, as well as multidrug resistant TB and TB and HIV co-infection in children.

While the Bacillus Calmette-Guérin (BCG) vaccination is widely recognized as protecting against severe forms of TB in infants and children, there is less evidence that this protection can be extended to adults. Countries in Europe have large variations in their BCG policies, which are not clearly linked to national TB prevalence. Policies range from no use of BCG at all to vaccination of all children at birth, in infancy, at school entry and in later school years.

To date, considerable efforts on TB have been undertaken in the framework of Millennium Development Goal 6. However, improving children's health is also the prime focus of Millennium Development Goal 4. By acknowledging the fact that TB and other respiratory tract infections seriously impact on the health of children, it is important to work towards the elimination of TB in this vulnerable group to improve childhood health. In collaboration with  the Childhood TB Subgroup (DOTS Expansion  Working Group (DEWG)-STOP TB Partnership), ECDC is hosting an international meeting on childhood tuberculosis in Stockholm 17 and 18 March 2011  to highlight the challenges and to move the agenda forward in order to achieve a concerted advocacy approach and to hear the voice of children.WHO/Europe is participating in the event as a member of the steering group.

The Regional Director will deliver a video message to the international audience, highlighting children’s health as one of our corporate priorities.

(1) Guidance for national tuberculosis programmes on the management of tuberculosis in children. Geneva, World Health Organization, 2006 (WHO/HTM/TB/2006.371; WHO/FC H/CAH/2006.7).

(2) The 18 high priority countries are: Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Republic of Moldova, Romania, Russian Federation, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan. WHO Regional Office for Europe. Plan to stop TB in 18 high-priority countries in the European Region, 2007–2015. Copenhagen: 2007