8.1 Background

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Globally, children less than 15 years old comprise 10% of all TB cases. However, the source of TB infection in a young child is usually an adult, generally a family member living in the same household, with bacteriologically positive PTB. About 10.0 million people fell ill with TB in 2019. Of these, 56% (5.6 million) were men, 32% (3.2 million) were the woman and 12% (1.2 million) were children (aged <15); overall, 8.2% of people with TB were living with HIV. During 2019 in Bangladesh, an estimated 361,000 people developed TB; among them 33,000 were children. However, of these, only 291,600 TB patients were notified of which, only 4% were children. An estimated 69,400 people with TB were missed (not notified) of which, 20,670 were children. This indicates that there is substantial under-diagnosis of TB in children in Bangladesh. Adults with smear-positive PTB usually infect children, but not all children develop the disease after infection. The likelihood of developing disease is the highest shortly after infection. Infants and children under 5 years are at particular risk of developing TB disease. Immunosuppressive illnesses including measles, malnutrition, whooping cough, and HIV infection facilitate progression of TB infection to disease.