Two methods for setting child-focused tuberculosis care targets.

Area of Science:

• Public Health
• Epidemiology
• Global Health

Background:

• Tuberculosis (TB) programs require accurate estimates of child contacts needing care for effective resource allocation.
• Household contact investigations are crucial for controlling TB transmission.

Purpose of the Study:

• To develop and validate methods for estimating the annual number of child contacts (aged 0-14 years) requiring TB evaluation and treatment.
• To provide tools for TB programs to set programmatic targets for child contact management.

Main Methods:

• Developed two distinct methods for estimating child contacts requiring TB care.
• Method 1: Utilizes local data and simple formulas for estimation.
• Method 2: Employs a linear regression model using Demographic and Health Survey and World Bank data, combined with TB case notifications and risk estimates.

Main Results:

• Method 1 application in Malawi estimated ~21,000 child contacts annually needing evaluation and ~1900 TB diagnoses.
• Globally, Method 2 estimated over 2.4 million children under 5 and 5 million aged 5-14 live with adult TB patients.
• Projected TB cases among these child contacts: ~239,000 (<5 years) and ~419,000 (5-14 years), with millions more infected.

Conclusions:

• Available data can be effectively used to establish programmatic targets for TB evaluation and treatment in child contacts.
• The developed methods offer feasible approaches to improve care for children exposed to TB.