Tuberculosis cases are up among kids in Europe and Central Asia, health authorities warn

Cases of tuberculosis (TB), the world’s deadliest infectious disease, are up nearly 10 per cent year-over-year among children in Europe and Central Asia, according to a new report from international health agencies.

The data, which is from 2023, indicates that the European region is still grappling with the spillover effects of the COVID-19 pandemic, according to the report from the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization’s (WHO) Europe team.

And it comes as health officials warn that cuts to global aid could lead to a resurgence of TB worldwide.

In 2023, more than 172,000 people in the European region either got TB or had a relapse of the disease, similar to levels reported in 2022, the analysis shows. While TB deaths declined, they fell at a much slower rate than before the COVID-19 crisis.

That suggests many infected people went undiagnosed and untreated when the pandemic disrupted medical services, and that the consequences are now becoming apparent, the report said.

The toll on children also appears to be growing, with about 7,500 TB cases among kids under age 15 in the European region in 2023 – a 9.6 per cent increase from the year before, the report found.

More than 2,400 of these cases were reported among children under 5, who are at higher risk of serious illness and death.

“The current TB burden and the worrying rise in children with TB serves as a reminder that progress against this preventable and curable disease remains fragile,” Dr Hans Kluge, the WHO Europe director, said in a statement.

The findings indicate that TB is continuing to spread across Europe and that “immediate” public health efforts should be put in place to get the disease in check, the report said.

Why TB is so hard to eliminate

TB is caused by a bacterial infection that mainly affects the lungs but can also spread to other organs. Most people who are infected do not go on to develop the disease, but if they do, it can be dangerous, killing about 1.25 million people per year.

It also coincides with other critical health problems. In the European region, 15.4 per cent of people with new or reactivated TB also have HIV, which can progress to AIDS if left untreated, the report said.

TB primarily affects people living in poverty. It can be difficult to manage for a host of reasons, including delays in getting a diagnosis, whether patients take their medication on time, and a lack of access to the right treatments.

Patients must take TB medication daily for up to six months in order for it to be effective. 

Stopping treatment early can allow the bacteria to become resistant to drugs, making the disease harder to treat and allowing infections to spread.

First-line drugs worked for 75.5 per cent of patients in the European region, the analysis shows. For those with multi-drug resistant TB, medicines eventually worked for 59.7 per cent.

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Looking only at the European Union, Iceland, Liechtenstein, and Norway, health authorities said they do not know whether one in five children with TB actually completed treatment.

“With the rise of drug-resistant TB, the cost of inaction today will be paid by us all tomorrow,” ECDC director Dr Pamela Rendi-Wagner said in a statement.

Last week, the WHO warned that cuts to global aid are already undermining progress to eliminate the disease in 27 countries, mostly in Africa, Southeast Asia, and the Western Pacific. In nine countries, people are struggling to get TB medicine.

But Kluge said that TB programmes in Europe and Central Asia could also be affected by the cuts.

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Across the region, Russia had the most cases in 2023, followed by Ukraine, Uzbekistan, Kazakhstan, Turkey, and Romania.

The cuts mean “TB transmission may go unnoticed, further fuelling the rise in hard-to-treat strains,” Kluge said.