What Every Parent Should Know About TB and Schools in India

Hey there!

Did you know tuberculosis (TB) isn't just an adult issue? In India, a significant number of school-aged children are affected by TB each year. Let's dive into this hidden crisis, understand the challenges in diagnosing and treating TB among children, and explore how our healthcare and education systems can work together to tackle this issue.

The Silent Threat: TB Among School Children in India

TB is an infectious disease caused by the bacterium Mycobacterium tuberculosis. While it's often associated with adults, children are not immune. It's estimated that around 3.33 lakh (333,000) children aged 0–14 years in India become ill with TB each year, accounting for about 28% of the global childhood TB burden. 

Pause and Think: Did you realise that over a quarter of the world's childhood TB cases are in India?

Why Is TB in Children Overlooked?

Diagnosing tuberculosis in children is particularly challenging. The symptoms can be non-specific, including a persistent cough, fever, weight loss, and fatigue, which are often mistaken for other common childhood illnesses. Moreover, children, especially younger ones, may not produce sputum, making it difficult to obtain samples for testing. This results in underdiagnosis and delayed treatment, exacerbating the spread of the disease. 

Pause and Think: How many children might be suffering from TB without proper diagnosis due to these challenges?

Challenges in Treating Paediatric TB

Treating TB in children, even once diagnosed, comes with unique challenges. The conventional treatment protocol includes a combination of antibiotics for at least six months. Sticking to this extended treatment can be challenging, especially in resource-limited environments. Moreover, the unavailability of child-friendly TB medication formulations complicates administration, resulting in low compliance and a heightened risk of drug-resistant TB strains. 

Pause and Think: What can be done to make TB treatment more manageable for children and their families?

The Role of Schools in TB Control

Schools play a vital role in the early detection and prevention of TB among children. Regular health check-ups, awareness programmes, and prompt referral systems can assist in identifying symptomatic children at an early stage. Educating teachers and students about TB symptoms and the importance of early medical consultation can promote timely diagnosis and treatment, thus reducing transmission within the school environment.

Pause and Think: How can schools become proactive in the fight against TB?

BCG Vaccination: Limitations Beyond Early Childhood

In India, the Bacille Calmette-Guérin (BCG) vaccine is given to newborns to protect against tuberculosis. While it provides significant protection against severe forms of tuberculosis in young children, its efficacy decreases as they grow older. Studies have indicated that the BCG vaccine offers substantial protection for children under five but little to no protection for adolescents and adults.  

Pause and Think: Did you know the BCG vaccine's effectiveness decreases as children age?

The Hidden Danger of Latent TB

Latent TB infection (LTBI) occurs when a person is infected with Mycobacterium tuberculosis but does not show symptoms and is not contagious. However, without treatment, approximately 5–10% of individuals with LTBI will develop active TB disease during their lifetime. The risk of progression is higher in children and adolescents, highlighting the importance of early detection and treatment. 

Pause and Think: How many adolescents might unknowingly harbour latent TB that could become active?

Integrating Healthcare and Education Systems

Addressing tuberculosis among schoolchildren necessitates a collaborative approach involving both the healthcare and education sectors. Implementing school-based tuberculosis screening programmes can facilitate early detection. Training school staff to recognise tuberculosis symptoms and establishing referral pathways to healthcare facilities can ensure timely treatment. Furthermore, integrating tuberculosis education into the school curriculum can raise awareness and reduce student stigma.

Pause and Think: How can a partnership between schools and healthcare providers change the TB landscape for children?

Community Engagement and Support

Community involvement is crucial in combating TB. Parents, local leaders, and healthcare workers must collaborate to promote TB awareness, encourage early diagnosis, and support affected families. Community health programmes can provide resources and education to ensure that children complete their treatment regimens, thereby preventing the spread of TB.

Pause and Think: What role can your community play in supporting children with TB?

Conclusion

Tuberculosis among schoolchildren in India is a concealed crisis that requires urgent attention. By recognising the challenges in diagnosing and treating paediatric tuberculosis and promoting collaboration between the healthcare and education systems, we can strive towards a tuberculosis-free future for our children.

Quote to close: “Healthy children are more likely to attend school and are better equipped to learn.”