Epidemiological Assessment of Pediatric Tuberculosis in Pune, India, through Contact Tracing

This study ended in June 2016.

Approximately 1 million new cases of Tuberculosis occur among children each year around the world, with a large number of these cases occurring among indigent populations without access to adequate healthcare facilities (World Health Organization). Due to their high mobility, children are at high risk for TB disease, yet this vulnerable population has been largely neglected. This is due in part to the difficulty in diagnosis and management of pediatric TB. Detection of TB in children can be complicated because they often have a low burden of TB bacilli that do not show up in sputum smear tests and are often asymptomatic (National Institutes of Health). Thus, it is imperative to formulate adequate diagnosis and treatment programs for this high risk population.

India hosts 20% of the world’s TB burden and the Revised National TB Control Program (RNTCP) has generated data and effectively used the DOTS strategy to treat adult TB cases (TBC India). However, the burden of TB among children in India is largely unknown. In their 2009 goals, RNTCP made clear the need for research on the epidemiology of TB among children (TBC India).

In order to effectively diagnose and treat TB cases among children, it is essential to have data on the epidemiology and transmission dynamics of the disease among this population. The research should take into account the compounding effect of HIV infection and malnutrition on TB in children. Through understanding the common TB exposures sites and reasons for inadequate diagnosis and treatment, it will be possible to create future intervention programs.

Objective:
To assess the epidemiology and clinical characteristics present in children suspected to have TB in India. We propose to answer the following questions through this study:

1. What are the risk factors for pediatric TB? 
2. What is the household and transmission dynamics that have led to the TB case? 
3. How much knowledge about TB transmission do the families of the infected children have about the disease and is it accurate? 
4. What prevention methods are the families using in their homes to reduce the spread of TB?