The perception is that tuberculosis (TB) flares up among malnourished children from economically weaker sections. While this may have some degree of truth to it, doctors and TB experts agree that such a belief cannot be a general rule.
They point out that even children (below five years) from well-to-do families have been contracting the disease. This, they say, is due to improper dietary habits that affect immunity levels. Once immunity drops, the tuberculosis bacteria does not need much goading to start acting.
“Almost 80 per cent schoolchildren we interacted [with] in Hyderabad, Ranga Reddy and Nalgonda districts take milk and biscuits for breakfast. At around 10 a.m., they have another small snack of chips or other [kinds of] fast food. The first biggest meal of the day for them is at 12 p.m. when they consume rice,” says P. Sanjay Ram, programme coordinator of the Indian Development Foundation (IDF), which works on TB awareness among schoolchildren.
Mr. Ram, who interacted with children in nearly 200 schools in Telangana, observed that both parents of most children were working.
“Because they work, parents do not have enough time to prepare a solid breakfast. They cut corners and the child gets used to such eating habits. Parents should be very careful in nutritional aspects,” he suggests.
Presently, 26 per cent TB patients are children below five years in AP and in India.
“There is also no mechanism to protect from TB the children who live with TB positive family members. Detecting TB among children is also difficult because they do not cough up enough phlegm or sputum to conduct the required TB tests. Reliable diagnosis is a challenge,” says J. Venkateswara Rao, head of paediatrics at Gandhi Hospital.
There is no household contact investigation in place to determine the condition of children who live with kin who have TB and drug-resistant TB.
“Another major challenge in treating TB among children is that it’s mandatory for them to take medicines for at least six months. Sometimes, they also need to take medicines for 15-18 months. These TB drugs are pretty strong and have the potential to impact the liver. So, the doctors have to get their TB diagnosis right,” Dr. Rao advises.
