Related Experiment Video
Updated: Apr 24, 2026
System for Efficacy and Cytotoxicity Screening of Inhibitors Targeting Intracellular Mycobacterium tuberculosis
Published on: April 5, 2017
Commentary: a targets framework: dismantling the invisibility trap for children with drug-resistant tuberculosis
Mercedes C Becerra1, Soumya Swaminathan2
1Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, USA.
Insights
Drug-resistant tuberculosis (TB) disproportionately affects children, who are often overlooked due to diagnostic challenges and lack of contact investigation. A new network aims to end child deaths from pediatric drug-resistant TB.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- Tuberculosis (TB) remains a leading cause of death globally, with over a million fatalities annually.
- Children are particularly vulnerable to TB, yet often represent 'invisible casualties,' especially in cases of drug-resistant strains.
- Rising rates of drug-resistant TB pose a significant threat to global health, with children being equally susceptible but less frequently diagnosed.
Purpose of the Study:
- To address the critical issue of pediatric drug-resistant tuberculosis and reduce child mortality.
- To highlight the factors contributing to the invisibility of children with drug-resistant TB.
- To introduce a framework for targeted interventions and collective action to combat childhood drug-resistant TB.
Main Methods:
- Describing the challenges in diagnosing and treating drug-resistant TB in children, including diagnostic tool deficiencies and underutilization of contact investigation.
- Introducing the Sentinel Project on Pediatric Drug-Resistant Tuberculosis, a science-advocacy network.
- Establishing provisional annual targets for evaluating and treating children exposed to multidrug-resistant TB.
Main Results:
- Identifying four key factors that render children with drug-resistant TB 'invisible': disease presentation, diagnostic limitations, overreliance on diagnostics, and inadequate contact investigation.
- Proposing a framework with annual targets for different age groups (under 5 and 5-14 years) to guide interventions.
- Quantifying the number of children needing evaluation, treatment for TB disease, and preventive therapy.
Conclusions:
- Urgent action is needed to improve the detection and treatment of drug-resistant TB in children.
- The Sentinel Project and its target-based framework offer a structured approach to ending child deaths from this disease.
- Enhanced contact investigation and improved diagnostics are crucial for addressing the 'invisibility' of pediatric drug-resistant TB.
Abstract:
Tuberculosis (TB) is an airborne infectious disease that is both preventable and curable, yet it kills more than a million people every year. Children are highly vulnerable, but often invisible casualties. Drug-resistant forms of TB are on the rise globally, and children are as vulnerable as adults but less likely to be counted as cases of drug-resistant disease if they become sick. Four factors make children with drug-resistant TB 'invisible': first, the nature of the disease in children; second, deficiencies in existing diagnostic tools; third, overreliance on these tools; and fourth, our collective failure to deploy one effective tool for finding and treating children - contact investigation. We describe a nascent science-advocacy network - the Sentinel Project on Pediatric Drug-Resistant Tuberculosis - whose goal is to end child deaths from this disease. Provisional annual targets, focused on children exposed at home to multidrug-resistant TB, to be updated every year, constitute a framework to focus attention and collective actions at the community, national, and global levels. The targets in two age groups, under 5 and 5-14 years old, tell us the number of: (i) children who require complete evaluation for TB disease and infection; (ii) children who require treatment for TB disease; and (iii) children who would benefit from preventive therapy.
Related Concept Videos
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:16Therapeutic Drug Monitoring: Overview and Classification
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion