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India has shown the highest level of political commitment by targeting TB elimination by 2025 with the National Strategic Plan (NSP 2017- 25) END TB to enhance the coverage, quality, equity, efficiency, and effectiveness under National Tuberculosis Elimination Programme (NTEP) framework. India accounted for 34 per cnet of combined total global TB deaths. However, the present rate of approximately 3 per cent annual decline in TB incidence would need to be accelerated to about 11 per cent to achieve the 2030 SDGs targets. Childhood TB has been recently termed a silent epidemic by the International Union against Tuberculosis and Lung Diseases. In India, about 3,42,00 cases of paediatric TB (PTB) are estimated to occur every year accounting for 31 per cent of the global burden and 13 per cent of the overall TB burden in the country.
PTB is one of the 10 major causes of mortality globally among children (population age less than 15 years). The disease also causes high out-of-pocket expenditure (OOPE) and catastrophic costs resulting in huge financial burdens on individuals and families.
India also has more than a million 'missing' cases every year that are not notified and remain either undiagnosed or inadequately diagnosed. Paediatric tuberculosis notifications (0 14 years) is stagnant for the last few years at 6 per cent, while as per estimate it should be 10 per cent. There is an approximation that we are still not able to notify 55 per cent of pediatric tuberculosis cases. TB reporting gap is highest among the age group 0-5 years of 69 per cent while among 6 to 14 years the gap is 40 per cent. To achieve the 2025 TB goal, it is imperative that priority attention should be given to the paediatric age group (0-18 years) tuberculosis through periodic screening involving multiple stakeholders.
Minimum attempts are made in practice by both public and private healthcare providers to integrate paediatric TB screening into general child health services or to provide active case-detection interventions for children. Low-case detection among children has been identified as a key factor contributing to the overall low-case notification.
We are committed to supporting the government to eliminate TB through our association with the Central Tuberculosis Division (CTD), a section of the Ministry of Health and Family Welfare (MoHFW) as Ni-kshay Mitra under the government's initiative called Community Support To TB Patients. We are supporting 270 paediatric children for nutritional support from the State of Haryana to address food insecurity and well-being for better treatment outcomes at the household and community level. We are also supporting Gurugram TB cells in strengthening tuberculosis OPDs, IPDs, and laboratories for the diagnosis of latent TB through the supply of equipment and logistics to deliver quality tuberculosis management services, especially for children and adolescents.
The article is written by Dr. Vikas Kaushal, Head Health, Save the Children (Bal Raksha Bharat).