Every year, more than one million children fall ill with tuberculosis (TB) globally, and about a quarter die from this potentially preventable and curable disease. According to the World Health Organization, TB is one of the ten most frequent causes of death among children under five years of age.
The main challenge remains the correct and timely diagnosis of TB, especially in resource-constrained settings. TB is more difficult to diagnose in children compared to adults because there are far fewer TB bacteria present in children than in adults. This means that in many children the diagnosis of TB is missed.
To test young children for TB, we currently need to collect mucus from the lungs (sputum) or liquid contents of the stomach which are difficult to obtain from children and must be collected in a hospital. Diagnosis of TB in children with HIV infection is even more difficult and they are more likely to develop TB compared to children not infected with HIV. Despite advances in TB diagnostic tests in the last decade, these have not impacted significantly on paediatric TB. New and different ways to diagnosis TB in children are urgently needed, especially for those infected with or exposed to HIV.