A Different Take on TB Rates Among South African Children

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If you look at the World Health Organization’s most recent statistics on tuberculosis among children in South Africa, the data doesn’t set off any alarm bells.

But Dr. Robin Wood, director of the Desmond Tutu HIV Centre at the University of Cape Town, says that’s because the WHO isn’t looking at right the set of statistics. And he’s ringing alarms with his own take on the numbers.

The WHO reports that the number of smear positive TB cases among children under age 15 is 30 per 100,000 in South Africa. But Dr. Wood points out that the WHO uses a numerator—smear positive cases—that’s too small, because young children don’t usually get smear positive TB. In addition, the WHO’s denominator—children ages zero to 15—is too big, because children aged 8 to 15 generally don’t get TB.

“That’s the golden age of TB,” he said, during which “there’s hardly any TB. Why it is, nobody knows.”

Dr. Wood says WHO stats on childhoold TB in South Africa are falsely reassuring

Dr. Wood says WHO stats on childhoold TB in South Africa are falsely reassuring

So the WHO statistics “lull us into a false sense of security,” Dr. Wood said at a presentation before the Global Health Council in Washington on Thursday.

His own data, based on surveys he has conducted in Cape Town, shows there are 770 TB cases per 100,000 children under age 15. Narrowed down to children under age 2, Dr. Wood said the data show 1,750 cases per 100,000. “Those are astronomically high rates,” he said.

Dr. Wood says that while his data is limited to Cape Town, this is almost certainly a much broader problem and notes that no one has really been measuring this since the 1950s. These children, he said, are the “canaries” in the coal mine, telling the world about a terrible and growing problem.

Dr. Wood is in Washington this week for a series of policy forums, Capitol Hill meetings, community sessions, and press interviews organized by the IDSA/HIVMA Center for Global Health Policy. This is part of the Global Center’s efforts to make the voices of developing country physicians heard in American policy debates.

Click here to read a Voice of America story detailing Dr. Wood’s research on TB & HIV in South Africa and here to read an NPR piece citing Dr. Wood on the success of ARV roll-out in resource-poor countries.

You can also watch this live, interactive webcast on the global threat of tuberculosis and the U.S. strategy for combating this deadly epidemic. Dr. Wood was among the participants; the expert panel also included Center Director Christine Lubinski and representatives from USAID and NIAID.

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