Epidemiology and disease burden of tuberculosis in children: a global perspective

Figures & data

Figure 1 Risk factors for tuberculosis exposure, infection and disease in children.

Abbreviations: BCG, Bacillus Calmette–Guérin; HIV, human immunodeficiency virus; TB, tuberculosis.

Figure 2 Age- and gender-related differences of tuberculosis incidence in hypothetical high and low tuberculosis incidence populations.

Notes: Reproduced with permission of the International Union Against Tuberculosis and Lung Disease. Copyright © The Union. Donald PR. Childhood tuberculosis: the hidden epidemic. Int J Tuberc Lung Dis. 2004;8(5):627–629.⁸

Table 1 Tuberculosis cases in adults and children within the European region in 2011

Area	Age ≤15 years			Age >15 years
	Number of cases	Percentage of total burden*	Incidence (number of cases/100,000 per year)	Number of cases	Percentage of total burden*	Incidence (number of cases/100,000 per year)
EU	3,190	4.4	4.0	69,084	95.5	16.1
Non-EU	8,762	2.9	11.2	210,206	69.1	66.6
Total ER	11,952	3.2	7.6	279,290	75.2	37.6

Note:

* Percentages calculation based on all cases with age notified.

Abbreviations: EU, European Union; ER, European region.

Table 2 Tuberculosis cases in children (≤15 years old), by age group and origin in the EU in 2011

Country	Native				Foreign origin				Unknown				Total
	<5 years		5–15 years		<5 years		5–15 years		<5 years		5–15 years		<5 years		5–15 years
	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
France	101	63.5	58	36.5	20	23	67	77	4	44.4	5	55.6	125	49	130	51
Romania	299	38	472	61.2	4	80	1	20	0	0	0	0	303	39	473	61
Spain	267	63	157	37	31	28.4	78	71.6	3	37.5	5	62.5	301	55.6	240	44.4
UK	116	44.6	144	55.4	18	12.9	121	87.1	6	42.9	8	57.1	140	33.9	273	66.1
Total EU	1,174	46.6	1,334	53.4	159	25.6	462	74.4	20	39.2	31	60.8	1,353	42.4	1,837	57.6

Abbreviation: EU, European Union.

Figure 3 Tuberculosis case reports and rates by age group and place of birth, UK, 2012.

Notes: Reproduced from Public Health England. Tuberculosis in the UK 2013 Report. Public Health England: London, UK; 2013. Available from: http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317139689583.⁷⁸ © Crown copyright 2013.

Table 3 New tuberculosis case notifications in 2012, by case type and age disaggregation

	Smear-positive	Smear-negative*	Extra-pulmonary
Total notifications	2,568,789	1,935,971	817,462
Countries disaggregating by age	2,551,136	1,597,530	678,953
Countries not disaggregating	17,653	338,441	138,509
by age (percentage of total notifications disaggregated)	(99%)	(83%)	(83%)
Number of countries that reported notifications disaggregated by age (number of high-burden countries)**	204 (22)	184 (14)	184 (14)
Total childhood notifications from countries disaggregating by age	46,488	163,477	91,308
Total estimated childhood notification among all countries	349,000

Notes:

* This includes reported cases for whom smear results were unknown or not done

** an additional nine countries reported zero tuberculosis cases for 2012 and three countries had not reported data to the World Health Organization by July 2013.

Table 4 The regional breakdown of new tuberculosis case notifications in 2011, by age and World Health Organization region

	0–14 years	15–44 years	45–64 years	≥65 years	% Aged <15 years	Male/female ratio
Afghanistan	669	8,574	3,319	1,227	5	0.51
Bangladesh	932	53,585	30,877	13,554	<1	1.9
Brazil	692	25,270	11,080	3,211	2	2.2
Cambodia	73	6,810	6,412	2,581	<1	1.2
People’s Republic of China	1,378	173,523	128,585	73,519	<1	2.6
DR Congo	3,379	47,529	17,207	3,206	5	1.2
Ethiopia	3,830	38,518	6,272	1,074	8	1.2
India	12,985	388,447	187,705	53,174	2	2.2
Indonesia	1,714	115,631	67,378	13,074	<1	1.5
Kenya	985	29,884	5,207	1,009	3	1.6
Mozambique					–	–
Myanmar	307	23,902	14,198	3,907	<1	1.9
Nigeria	1,107	34,559	9,604	2,167	2	1.6
Pakistan	3,895	64,309	27,495	10,034	4	1.1
Philippines	953	51,919	31,069	6,935	1	2.4
Russian Federation	51	18,066	9,477	1,597	<1	2.7
South Africa	3,404	94,427	27,552	4,387	3	1.2
Thailand	114	14,980	11,862	6,213	<1	2.4
Uganda	695	18,486	4,842	917	3	1.8
UR Tanzania	411	17,149	5,047	1,508	2	1.8
Vietnam	95	23,404	18,271	8,949	<1	3.0
Zimbabwe	326	9,953	1,879	438	3	1.2
High-burden countries	37,995	1,258,925	625,338	212,681	2	1.9
Africa	19,183	427,731	114,303	23,574	3	1.4
America	2,337	62,127	27,495	11,311	2	1.8
Eastern Mediterranean	5,763	105,833	42,736	16,303	3	1.2
Europe	391	46,807	24,197	6,962	<1	2.3
Southeast Asia	17,144	626,659	329,687	93,857	2	2.0
Western Pacific	2,880	272,434	196,490	104,444	<1	2.4
Global	47,698	1,541,591	734,908	256,451	2	1.9

Notes: Reproduced with permission from the World Health Organization. Global Tuberculosis Report. Geneva: World Health Organization; 2012: WHO/HTM/TB/2012.6. Available from: http://apps.who.int/iris/bitstream/10665/75938/1/9789241564502_eng.pdf.³ Copyright © 2012, World Health Organization.

Figure 4 The strategy employed by the World Health Organization to arrive at the estimate of childhood tuberculosis cases.

Abbreviations: TB, tuberculosis; WHO, World Health Organization.

DonaldPRChildhood tuberculosis: the hidden epidemicInt J Tuberc Lung Dis20048562762915137546

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Public Health EnglandTuberculosis in the UK 2013 ReportPublic Health EnglandLondon, UK2013 Available from: http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317139689583Accessed November 1, 2013

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World Health OrganizationGlobal Tuberculosis ReportGenevaWorld Health Organization2012 WHO/HTM/TB/2012.6. Available from: http://apps.who.int/iris/bitstream/10665/75938/1/9789241564502_eng.pdfAccessed August 1, 2013

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