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Are TB control programmes in South Asia ignoring children with disease? A situational analysis
  1. Sadia Shakoor1,2,
  2. Farah Naz Qamar2,
  3. Fatima Mir2,
  4. Anita Zaidi2,
  5. Rumina Hasan1
  1. 1Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan
  2. 2Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
  1. Correspondence to Professor Rumina Hasan, Department of Pathology and Microbiology, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan; rumina.hasan{at}


Paediatric tuberculosis (TB) has long been an evasive entity for public health practitioners striving to control the disease. Owing to difficulty in diagnosis of paediatric TB, incidence estimates based on current case detection fall short of actual rates. The four high-burden countries in South Asia (SA-HBC)—Afghanistan, Pakistan, India and Bangladesh—alone account for >75% of missed TB cases worldwide. It follows that these countries are also responsible for a large although unmeasured proportion of missed paediatric cases. In view of current Millennium Development Goals recommending a scale-up of paediatric TB detection and management globally, there is a dire need to improve paediatric TB programmes in these high-burden countries. Inherent problems with diagnosis of paediatric TB are compounded by programmatic and social barriers in SA-HBC. We have reviewed the current situation of TB control programmes in SA-HBC countries based on published statistics and performed a strengths, weaknesses, opportunities and threats situational analysis with a view towards identifying critical issues operant in the region posing barriers to improving paediatric TB control.

  • Pediatric
  • Tuberculosis
  • South Asia
  • National tuberculosis control programs
  • health systems

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