Prevention of tuberculosis in household members: estimates of children eligible for treatment

摘要

Objective To estimate of the number of children younger than 5?years who were household contacts of people with tuberculosis and were eligible for tuberculosis preventive treatment in 2017. Methods To estimate the number of eligible children, we obtained national values for the number of notified cases of bacteriologically confirmed pulmonary tuberculosis in 2017, the proportion of the population younger than 5?years in 2017 and average household size from published sources. We obtained global values for the number of active tuberculosis cases per household with an index case and for the prevalence of latent tuberculosis infection among children younger than 5?years who were household contacts of a tuberculosis case through systematic reviews, meta-analysis and Poisson regression models. Findings The estimated number of children younger than 5?years eligible for tuberculosis preventive treatment in 2017 globally was 1.27?million (95% uncertainty interval, UI: 1.24–1.31), which corresponded to an estimated global coverage of preventive treatment in children of 23% at best. By country, the estimated number ranged from less than one in the Bahamas, Iceland, Luxembourg and Malta to 350?000 (95% UI: 320?000–380?000) in India. Regionally, the highest estimates were for the World Health Organization (WHO) South-East Asia Region (510?000; 95% UI: 450?000–580?000) and the WHO African Region (470?000; 95% UI: 440?000–490?000). Conclusion Tuberculosis preventive treatment in children was underutilized globally in 2017. Treatment should be scaled up to help eliminate the pool of tuberculosis infection and achieve the End TB Strategy targets.