A step in the right direction for children with tuberculosis

Pneumonia is a leading cause of morbidity and mortality in children,1 but a notable number of these children actually have tuberculosis.2 1 million children become sick from tuberculosis each year and more than 200 000 die of the treatable disease.3 Most of these deaths occur in children who are undiagnosed, a common phenomenon, since making a paediatric tuberculosis diagnosis is fraught with challenges, ranging from obtaining samples to finding the bacteria.4 Many places still rely on the 100-year-old sputum smear microscopy test because it is cheap. The diagnostic situation is even more dire among young children who were deliberately overlooked in the public health approach to tuberculosis because they were not felt to contribute to transmission.5 As a result, there are no point-of-care tuberculosis tests that can be deployed on samples that are easy to obtain from children. [...]when the analysis considered the nutritional status of the child, those with severe acute malnutrition in the intervention group showed a 12-week mortality of 17·8% whereas the control group had a 12-week mortality of 23·8%, suggesting the intensified diagnostic strategy for tuberculosis did have an effect on mortality among malnourished children.