title: Are TB control programmes in South Asia ignoring children with disease? A situational analysis.
abstract: Paediatric tuberculosis (TB) has long been an evasive entity for public health practitioners striving to control the disease. Owing to difficulty in diagnosis of paediatric TB, incidence estimates based on current case detection fall short of actual rates. The four high-burden countries in South Asia (SA-HBC)-Afghanistan, Pakistan, India and Bangladesh-alone account for >75% of missed TB cases worldwide. It follows that these countries are also responsible for a large although unmeasured proportion of missed paediatric cases. In view of current Millennium Development Goals recommending a scale-up of paediatric TB detection and management globally, there is a dire need to improve paediatric TB programmes in these high-burden countries. Inherent problems with diagnosis of paediatric TB are compounded by programmatic and social barriers in SA-HBC. We have reviewed the current situation of TB control programmes in SA-HBC countries based on published statistics and performed a strengths, weaknesses, opportunities and threats situational analysis with a view towards identifying critical issues operant in the region posing barriers to improving paediatric TB control.
authors.affiliation: Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Sadia
authors.initials: S
authors.lastname: Shakoor
authors.affiliation: Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Farah Naz
authors.initials: FN
authors.lastname: Qamar
authors.affiliation: Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Fatima
authors.initials: F
authors.lastname: Mir
authors.affiliation: Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
authors.forename: Anita
authors.initials: A
authors.lastname: Zaidi
authors.affiliation: Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan.
authors.forename: Rumina
authors.initials: R
authors.lastname: Hasan
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D001208:Asia / Q000453:epidemiology; D002648:Child; D003140:Communicable Disease Control / Q000379:methods*; D003906:Developing Countries; D006801:Humans; D015994:Incidence; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000995:Antitubercular Agents
keywords: National tuberculosis control programs; Pediatric; South Asia; Tuberculosis; health systems