Related Experiment Video
Updated: Feb 24, 2026
A Tuberculosis Molecular Bacterial Load Assay TB-MBLA
Published on: April 30, 2020
The global burden of tuberculosis mortality in children: a mathematical modelling study
Peter J Dodd1, Courtney M Yuen2, Charalambos Sismanidis3
1School of Health and Related Research, University of Sheffield, Sheffield, UK.
Insights
Tuberculosis caused nearly 239,000 deaths in children globally in 2015, with most occurring in those under 5 and not receiving treatment. This highlights a critical gap in child mortality data and a significant opportunity for intervention.
Area of Science:
- Global Health
- Epidemiology
- Pediatric Infectious Diseases
Background:
- Tuberculosis (TB) is a significant global health issue, with millions of cases annually.
- Paediatric TB represents a substantial portion of the global TB burden, yet mortality data is lacking.
- Children, especially younger ones, are highly vulnerable to severe TB and associated mortality.
Purpose of the Study:
- To estimate the global mortality burden of TB in children younger than 15 years.
- To provide age-disaggregated mortality estimates for paediatric TB, addressing a gap in official child mortality statistics.
- To utilize a novel approach independent of vital registration data for comprehensive mortality assessment.
Main Methods:
- A mathematical modelling study was conducted for 217 countries and territories.
- A case-fatality-based approach was employed, integrating paediatric TB notification data, HIV, and antiretroviral treatment (ART) data.
- Systematic review evidence on case-fatality ratios was applied to WHO paediatric TB incidence estimates, disaggregated by age, HIV, and treatment status.
Main Results:
- An estimated 239,000 (95% UI 194,000–298,000) deaths from TB occurred in children under 15 globally in 2015.
- Eighty percent of these deaths (191,000) were in children younger than 5 years.
- Over 96% of all paediatric TB deaths occurred in children not receiving TB treatment, with significant burdens in Southeast Asia and Africa, and a notable proportion in children with HIV.
Conclusions:
- Tuberculosis is a leading cause of death in children globally and has been overlooked in child mortality analyses.
- The vast majority of paediatric TB deaths occur in children not receiving treatment, indicating substantial potential for mortality reduction.
- Addressing paediatric TB, particularly among vulnerable populations and those with HIV, is crucial for reducing child mortality worldwide.
Background:
Tuberculosis in children is increasingly recognised as an important component of the global tuberculosis burden, with an estimated 1 million cases in 2015. Although younger children are vulnerable to severe forms of tuberculosis disease, no age-disaggregated estimates of paediatric tuberculosis mortality exist, and tuberculosis has never been included in official estimates of under-5 child mortality. We aimed to produce a global mortality burden estimate in children using a complementary approach not dependent on vital registration data.
Methods:
In this mathematical modelling study, we estimated deaths in children younger than 5 years and those aged 5-14 years for 217 countries and territories using a case-fatality-based approach. We used paediatric tuberculosis notification data and HIV and antiretroviral treatment estimates to disaggregate the WHO paediatric tuberculosis incidence estimates by age, HIV, and treatment status. We then applied systematic review evidence on corresponding case-fatality ratios.
Findings:
We estimated that 239 000 (95% uncertainty interval [UI] 194 000-298 000) children younger than 15 years died from tuberculosis worldwide in 2015; 80% (191 000, 95% UI 132 000-257 000) of these deaths were in children younger than 5 years. More than 70% (182 000, 140 000-239 000) of deaths occurred in the WHO southeast Asia and Africa regions. We estimated that 39 000 (17%, 23 000-73 000) paediatric tuberculosis deaths worldwide were in children with HIV infections, with 31 000 (36%, 19 000-59 000) in the WHO Africa region. More than 96% (230 000, 185 000-289 000) of all tuberculosis deaths occurred in children not receiving tuberculosis treatment.
Interpretation:
Tuberculosis is a top ten cause of death in children worldwide and a key omission from previous analyses of under-5 mortality. Almost all these deaths occur in children not on tuberculosis treatment, implying substantial scope to reduce this burden.
Funding:
UNITAID, National Institutes of Health, and National Institute for Health Research.
Related Concept Videos
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...
01:49Probability Laws
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
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...
01:28Pulmonary 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...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories: