Preventive Program Helping Achieve WHO's Child TB Goal

Thanks to the national tuberculosis preventive program, a man in HCM City's Tan Phu District who was diagnosed with TB is not afraid he will transmit the disease to his infant son. The man, who asked not to be named, had exclaimed earlier to doctors in his district clinic: “How worrying! I am afraid of giving the disease to my nine-month-old son. What can I do to prevent transmission?” They offered to put his son through the national program for children under five, which has been carried out in HCM City since late 2013. Under this, children whose relatives had TB were encouraged to get tested, Dr Nguyen Hong Nguyen, the clinic's deputy head, said. If the tests proved negative for TB germs, they were given free Isoniazid to drink every day for six months to prevent TB, he said. Isoniazid is an antibiotic used both to treat and prevent TB. The children in the program were monitored for side effects and examined every month, Nguyen said, assuring that the drug does not have side effects. Any child testing positive got free treatment, he added. The World Health Organization estimated in 2013 that globally up to 80,000 children die of TB and over half a million are infected each year. The actual incidence of TB among children was possibly higher given the difficulties in diagnosing the disease in children, WHO had said. In Vietnam, nearly 180,000 new cases, including 18,000 children, were found and treated every year. Dang Minh Sang, head of the National Tuberculosis Control Division's southern region based in Pham Ngoc Thach, told a recent conference on TB diagnosis equipment, that children accounted for a mere around 2% of the cases only because TB was difficult to diagnose in children due to a shortage of equipment. In Vietnam the diagnosis was based on sputum tests, and obtaining children's sputum was very difficult, he said. This year, by late March, Pham Ngoc Thach Hospital had treated 360 child TB patients, he said. Four of them had multidrug-resistant TB, he said, adding they had been infected by relatives with TB. Truong Huu Khanh, head of the hospital's neurology and infectious diseases ward, warned that young children were most likely to get TB from family members. Earlier this month the HCM City Paediatrics Hospital No.1 admitted an 18-month-old baby with TB meningitis, who had got the TB bacteria from his father who was being treated. According to the US's Centers for Disease Control and Prevention, children can develop TB at any age, but the most severe forms are most common between one and four years of age. Children can get TB immediately after being infected or can get the disease at any time later in life. They can even infect their own children, decades later, if not treated. Sang said it was vital to implement the TB prevention program to achieve WHO's goal of zero child deaths from TB. District TB clinics and reproductive and child health centers provided the public with information about the program, he said. By the end of the first quarter this year 62% of all children in the city who were in close contact with TB patients were attending the program, he said. The rest had refused because they were worried about side effects despite doctors' assurances that the drug did not cause more harm than TB, he added. (Vietnam News May 12 p5)