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Published on: September 5, 2017
Pediatric tuberculosis in India: Justice and human rights
Kinsey Mannebach1, Anne Dressel2, Leighann Eason2
1Joseph J Zilber School of Public Health, University of Wisconsin-Milwaukee, Minneapolis, Minnesota, USA.
Insights
Tuberculosis (TB) disproportionately affects children in India. Addressing root causes like poverty and improving sanitation are crucial for primary prevention of this infectious disease.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- Tuberculosis (TB) remains the leading infectious cause of death globally, with India bearing a significant burden.
- Vulnerable populations, including pregnant women and children, face heightened risks and diminished self-protection against TB.
- Factors like malnutrition, HIV, air pollution, maternal education, healthcare access, poverty, and sanitation influence TB susceptibility and severity.
Purpose of the Study:
- To highlight the critical need for primary prevention strategies for pediatric tuberculosis in India.
- To shift focus from clinical and tertiary prevention to upstream determinants of health.
- To advocate for evidence-based interventions addressing social and environmental factors contributing to pediatric TB.
Main Methods:
- Literature review focusing on clinical and upstream factors influencing TB.
- Analysis of risk factors, including socioeconomic, environmental, and healthcare access determinants.
- Examination of current prevention strategies, emphasizing the gap in primary prevention.
Main Results:
- Existing literature predominantly focuses on clinical aspects and secondary/tertiary prevention (case finding, treatment).
- Upstream factors such as wealth equity, environmental regulation, maternal education, sanitation, and healthcare access are underemphasized.
- Pediatric TB in India is influenced by a complex interplay of socioeconomic and environmental determinants.
Conclusions:
- Primary prevention strategies, including improved sanitation, air quality monitoring, women's education, and enhanced healthcare access, are cost-effective for pediatric TB in India.
- Public health professionals must advocate for vulnerable populations and address the social justice and human rights dimensions of TB.
- Addressing root causes is essential for combating extremely drug-resistant TB and preventing cross-border infectious disease spread.
Abstract:
Tuberculosis (TB) is the deadliest infectious disease across the world, with the greatest burden occurring in India. Pregnant women and children are especially vulnerable to adverse effects from infection, and they tend to have diminished ability to protect themselves. Malnutrition, HIV, and other causes of immune suppression such as exposure to air pollution make one more prone to serious illness or death from TB infection. Risk factors are influenced by maternal education, access to health care, poverty, nutrition, healthcare stigma, and sanitation, among others. Current literature is heavily clinical, lacking focus on upstream factors, with a skew toward secondary and tertiary prevention strategies (i.e., case finding and treatment), and less emphasis on primary prevention (e.g., wealth equity and environmental regulation). Given concerns with extremely drug resistant TB and because infectious diseases can permeate National borders, public health nurses, and other healthcare professionals must educate themselves and advocate on behalf of vulnerable populations such as children in India. Improved sanitation, air quality monitoring, women's education, and increased access to health care are cost-effective and evidence-based strategies to address pediatric TB in India, a challenge which is grounded in human rights and justice.
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