Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study

Dodd, Peter J
Gardiner, Elizabeth
Coghlan, Renia
Seddon, James A

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Publication date

August 2014

DOI

10.1016/S2214-109X(14)70245-1

Publisher

Dodd et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.

Abstract

SummaryBackgroundConfirmation of a diagnosis of tuberculosis in children (aged <15 years) is challenging; under-reporting can result even when children do present to health services. Direct incidence estimates are unavailable, and WHO estimates build on paediatric notifications, with adjustment for incomplete surveillance by the same factor as adult notifications. We aimed to estimate the incidence of infection and disease in children, the prevalence of infection, and household exposure in the 22 countries with a high burden of the disease.MethodsWithin a mechanistic mathematical model, we combined estimates of adult tuberculosis prevalence in 2010, with aspects of the natural history of paediatric tuberculosis. In a household model, we est...