TB detection in children still takes weeks

Trials based on a London study that rules out the disease within 48 hours underway.

Tuberculosis (TB) is among the top 10 causes of death among children worldwide. As yet another World TB Day was observed on March 24,experts feel that children with TB are given low priority in most national health programmes.

Recent technological advancements in diagnosis of TB in adults,in fact,have not been validated in children. Trials of new drugs and development of paediatric formulations of standard first- and second-line drugs are lagging behind,says Dr Soumya Swaminathan,Coordinator,Research on Neglected Priorities,WHO special programme for research and training in tropical diseases.

She has examined the current status of diagnosis,prevention and treatment of TB in children and highlights knowledge gaps and research priorities in these areas in a recent issue of the Clinical Infectious Diseases Journal.

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TB is difficult to diagnose as many of its symptoms,such as fever,fatigue,and loss of appetite,are commonly found in many other conditions.

The combination of ELISpot-Plus and tuberculin skin testing is able to rule out TB within 48 hours,providing a much quicker result than the existing testing methods,for which results take up to several weeks,Professor Ajit Lalvani,from the National Heart and Lung Institute at Imperial College,London,has found out as part of his research.

Back home,researchers at National AIDS Research Institute (NARI) have tied up with the B J Medical College,Pune,to conduct trials based on similar principles and detect a test to diagnose TB in children.

Dr R S Paranjape,Director,NARI,says: We will evaluate a new modified Elispot test among 400 children. Barring routine microscopy and culture tests,there is no rapid test to easily diagnose TB in children.

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Paranjape said that they would apply the same principles adopted in the London study. If the test is successful then we will be able to detect TB in children in a matter of days than weeks, says Dr Renu Bharadwaj,Dean,B J Medical College.

Refinement of existing tools and development and testing of new tools are urgently required to improve diagnosis and treatment of TB in children,says Dr V D Ramanathan,scientist,Tuberculosis Research Centre,Chennai,who points out that TB has been reported to be the third most common cause of death in HIV-infected children with a clinical diagnosis of acute severe pneumonia.

Of the one million estimated cases of TB in children worldwide,75 per cent occur in the 22 high-burden countries. In 2009,India had the highest number of TB cases in the world (approximately 2 million new patients),suggesting that the prevalence in children is likely to be equally high.

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