[Comment] Tuberculosis in children: under-counted and under-treated

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Lancet Global Health
The Lancet Global Health is The Lancet's first gold open-access title and focuses on original research, commentary, correspondence and blogs on topics including maternal and child health, infectious and noncommunicable diseases, mental health, and more. The Editor is Zoë Mullan.

Tuberculosis is the number one infectious cause of death worldwide1 but remains underappreciated as a cause of morbidity and mortality in children. Because many children have difficulty expectorating sputum and because paediatric tuberculosis is usually pauci-bacillary and often extra-pulmonary, paediatric tuberculosis is especially difficult to diagnose with standard sputum-based assays. Predicted associations between paediatric and adult tuberculosis burden2,3 place paediatric incidence at 10% of total global tuberculosis incidence, but tuberculosis notification rates (already inadequate in adults) are lowest in children, with roughly 40% of incident cases in children younger than 15 years having been diagnosed and notified in 2015.

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[Comment] Tuberculosis in children: under-counted and under-treated