More children die from tuberculosis in India than anywhere else in the world. The disease killed 60,000 children below the age of 15 in the country in 2015. This represents roughly 25 percent of the global count.
India holds a disproportionately high number of cases: TB is a disease that is endemic in low to middle income countries (LMICs). These countries often lack the financial and medical resources needed to provide adequate treatment. In some nations, the disease is either misdiagnosed or not diagnosed at all in large numbers.
A study published recently in The Lancet shows that of the 2.39 lakh (239,000) children killed globally by TB, 80 percent were below the age of five. This warrants a more vigourous approach to the diagnosis and treatment of the disease, as it can be considered one of the foremost threats to the nation’s children. India’s under-five mortality rate is 48 deaths per 1,000 live births, the third highest of the South Asian Association for Regional Cooperation (SAARC) countries. TB is evidently a significant contributor to this.
Perhaps a more alarming statistic still, the study also noted that of the children killed globally, 96 percent were not receiving any kind of treatment. The disease may be being undiagnosed, — possibly due to a lack of access to healthcare facilities, a common issue in rural communities. An alternative possibility is that the children have been diagnosed, but those in poverty cannot afford the medication.
tuberculosis is a treatable condition with a course of antibiotics such as isoniazid or rifampin. Though in recent years concern has grown over the rising prevalence of drug resistant TB, which has been further hindering efforts to eliminate TB in India. However, as only a small minority of the children who died from the condition were receiving treatment, drug resistant TB cannot be implicated.
The implication is that in countries where TB is endemic, deaths are occurring due to the lack of access to treatment, either through geographical isolation from healthcare facilities, or through poverty. It has been suggested that malnutrition also plays a role, as it causes severe weakness in a person’s immune system and therefore makes them both more prone to new infections, as well as more likely to face recurrent infection.
In southern Indian states, both malnutrition and alcoholism have been found to play a large role in the vulnerability to TB infection. Both of these traits are commonly found in those from an impoverished background, further highlighting the link between TB mortality and poverty.
To make progress towards the elimination of tuberculosis from India, the lack of diagnosis and follow up treatment needs to be addressed. Failing to resolve the situation as a priority health concern will allow drug resistant TB to continue to flourish in India, making the situation progressively more difficult to address.