Adolescent TB: an overlooked group

Adolescents in low- and middle-income countries experience a substantial increase in their risk of tuberculosis, but remain overlooked as a target population in both TB policy and treatment. This is the conclusion of a review published this week in the Lancet Child & Adolescent Health.

" TB diagnosis and treatment can be challenging with adolescents, who may fall into the cracks between child and adult health services"

The review’s first author, Dr Kathryn Snow, says that traditionally TB control has only considered “children” aged 0-14 and “adults” aged 15 and over, ignoring adolescents as a distinct group. But adolescents face a large increase in their risk of TB between age 12 and 24, due to their extensive social networks and changes in their immune systems.

“TB diagnosis and treatment can be challenging with adolescents, who may fall into the cracks between child and adult health services,” Dr Snow said. “Adolescents are in the process of learning how to manage their own health. They need age-appropriate care from health services that respect their autonomy, while also providing additional support in recognition that they are not yet fully independent adults. Some adolescents with tuberculosis have other complex health needs related to HIV or their mental health, and these patients can require additional support to help them finish their treatment.”

Dr Snow pointed to several areas that require further work: the need to scale up tuberculosis prevention in this age group, including through potential new vaccines, as well as a need to better understand the long-term consequences for young people who experience tuberculosis during this important developmental period.

Three authors of the review (Dr Kathryn Snow, Professor Steve Graham and Associate Professor Justin Denholm) are investigators with the NHMRC funded Centre for Research Excellence in Tuberculosis Control. Dr Snow (right) is a TB-CRE postdoctoral researcher at the Centre for International Child Health, Department of Paediatrics, University of Melbourne.

The review entitled 'Adolescent tuberculosis' can be found online here.

Snow KJ, Cruz AT, Seddon JA, Ferrand RA, Chiang SS, Hughes JA et al. Adolescent tuberculosis. Lancet Child Adolesc Health 2019; https://doi.org/10.1016/ S2352-4642(19)30337-2