The diagnosis of TB in children is complicated because it is often difficult for children to cough hard enough to produce sputum, the phlegm that is usually tested to diagnose TB.

Photo credit: Amy Fowler/USAID

Raj was three and a half years old when he suddenly got sick. A doctor took a sample of lung fluid, sent it for testing and the same day he was diagnosed with pediatric TB. He is now completely healthy.

Photo credit: Amy Fowler/USAID

USAID is pioneering the effort to diagnose tuberculosis (TB) and drug-resistant TB among children in India, as TB is one of the top 10 causes of childhood mortality. The USAID-funded Foundation for Innovative New Diagnostics (FIND) project works in collaboration with India's national TB program to improve diagnosis and treatment success rates for childhood TB.

The diagnosis of TB in children is complicated because it is often difficult for children to cough hard enough to produce sputum, the phlegm that is usually tested to diagnose TB. TB also mimics many other common childhood diseases such as pneumonia and viral infections. In the absence of bacteriological confirmation, diagnosis of childhood TB is largely based on clinical criteria, which results in both under and over-diagnosis.

Health providers collect samples from the patient, which are transported to a government facility for a GeneXpert test to diagnose whether the patient has TB or drug-resistant TB. Project staff inform the health provider of the test result via text message or email, usually the same day the test was taken. Since April 2014, the project has worked closely with India's National TB Program to test more than 27,000 children in four cities.

This is a very useful investment in serving the poor of this country" explains Dr. Varinder Singh, Pediatric TB expert at Kalawati Saran Hospital and Director Professor at Lady Harding Medical College. "FIND's project design eliminates delays that previously caused patient suffering, unnecessary use of antibiotics, and reduces health spending by families. An early diagnosis also helps to decrease the risk of developing other, more severe forms of childhood TB"