Two methods for setting child-focused tuberculosis care targets

摘要

>Objective: To allocate resources for household contact investigations, tuberculosis (TB) programs need estimates of the numbers of child contacts requiring care.>Design: We developed two methods to estimate annual numbers of child contacts aged 0–14 years requiring evaluation and treatment. Method 1 combines local data using simple formulas. Using publicly available data, Method 2 uses a linear regression model based on Demographic and Health Survey and World Bank data to estimate the number of children per household, then combines these results with case notifications and risk estimates of disease and infection.>Results: Applying Method 1 to data from Malawi indicated that every year ~21 000 child contacts require evaluation and ~1900 should be diagnosed with TB. Applying Method 2 to all countries suggested that, globally, 2.41 million (95% uncertainty interval [UI] 2.36–2.46) children aged <5 years, and 5.07 million (95%UI 4.81–5.34) children aged 5–14 years live in households of adult patients with known TB. Of these, 239 014 (95%UI 118 649–478581) and 419 816 (95%UI 140600–1 268805), respectively, will have TB. An additional 848 453 (95%UI 705838–1 017551) and 2660 885 (95%UI 2080517–3 413 189), respectively, will be infected.>Conclusion: It is feasible to use available data to set programmatic evaluation and treatment targets to improve care for child contacts of patients with TB.