Ethiopia marked a major milestone in its path towards zero TB death in children by launching its National Childhood TB Prevention and Control Roadmap on 30 July 2015 in Addis Ababa. The roadmap aims to guide implementation and strengthen prevention and management of childhood TB in the country. 

“The urgency of the problem of TB in children cannot be underestimated,” said Dr. Esther Aceng, speaking on behalf of the WHO Representative to Ethiopia in the launching workshop. “Up to 200 children die every day due to tuberculosis – a preventable and curable disease,” she added. WHO estimated that globally over 500,000 children were infected with TB and 80,000 died in 2013.

Ethiopia is among the 22 high burden countries with TB. According to Dr, Andargachew Kumsa, Coordinator of the National TB Control Program, it is not surprising if the country is also among high burden countries with childhood TB. Children are at high risk of developing TB due to their developing immune system. The majority of them tend to develop severe and disseminated form of TB within a year or two and could die even before their diagnosis. Childhood TB is also common among children with HIV, pneumonia and malnutrition.

However, the magnitude of childhood TB is not clear and children are suffering and dying silently. In 2013, 6.1 million cases of TB were notified to WHO by national TB programs but children accounted to only 6% of the reported cases, suggesting under-reporting. In Ethiopia, close to 13% of notified TB cases were children. The root causes of the neglect in childhood TB include under-reporting, difficulties in diagnosis and inadequate collaboration between TB and child health programmes. In addition, perceiving children with TB as less infectious and a misplaced faith in the protective efficacy of BCG vaccines are considered as barriers to mitigating childhood TB. 

WHO designed a global framework, which provides a clear guidance in responding to childhood TB. The roadmap of Ethiopia is aligned with the WHO global regional framework. It aims to achieve its goal of zero TB death in children by decentralizing comprehensive childhood TB services to primary health care level, strengthening hospital-based childhood TB, TB/HIV and drug resistant (DR)-TB services and establishing a center of excellence for pediatric services. 

Dr. Amha Fantaye, Director of Disease Prevention and Control Directorate at Ministry of Health, stated that the roadmap expresses the continued commitment of the Ethiopian Government to intensify childhood care, control and prevention, and thereby end the TB epidemic in Ethiopia. He called upon national stakeholders working on TB, TB/HIV, and maternal and child health to use the National Roadmap as a common guiding document in the quest to provide quality health services.

The launching workshop brought together representatives from the Ministry of Health, including the National TB Control Program, Disease Prevention and Control Directorate, Maternal and Child Health Directorate, regional health bureaus, the Ethiopian Public Health Institute, and the Ethiopian Pharmaceutical Fund and Supply Agency. Health development partners such as WHO, UNICEF, USAID, KNCV/ Challenge TB, German Leprosy Rehabilitation Association, Clinton Health Access Initiative, Centre for Disease Control, ICAP, the Ethiopian Paediatric Society, and medical universities were also present.

For more information, please contact

Dr Esther Aceng
Communicable Diseases Team Leader
email:  acenge [at] who.int

or

Kibnesh Chala
Communications consultant
email:  kibnesh [at] gmail.com