A life-threatening disease like malaria can kill people of any age. Helena, aged 57, from Timor-Leste knows this only too well.
After feeling pain and suffering from high fevers for three days straight, Helena was worried that she might have contracted the disease. “My whole body was weak, I had a headache and couldn’t even taste food because it was so bitter. I thought these might be signs of malaria,” she says.
A visit to a doctor in the capital of Dili confirmed her fears. “The doctor gave me a medicine to drink then two days later, I felt a little bit better. I could go out for a walk and look after my house.”
According to the World Health Organisation, Timor-Leste has made huge strides in the prevention and control of malaria. Over the last decade, the number of malaria cases has dropped from 220 for every 1,000 people to fewer than 1 case per 1,000.
This massive fall in infection rates has largely been due to improved diagnostics, political commitment from the Timorese government, and support from organisations like ChildFund Timor-Leste and the Global Fund to Global Fund to Fight AIDS, Tuberculosis and Malaria.
Tuberculosis (TB) remains a major, but often unrecognised, cause of disease and death among children in countries where the infection is endemic, like Papua New Guinea (PNG). Worldwide, of the 9.6 million people estimated to have fallen ill with the disease in 2014, one million were children.
Why providing TB treatment to vulnerable children is challenging
Getting treatment to children in these contexts is stymied by the lack of strategies and tools to guide diagnosis and treatment. The World Health Organisation lists the major reasons for this:
1. TB in children is rarely bacteriologically confirmed. As Dr Henry Welch, paediatrician and senior medical officer at Port Moresby General Hospital explains, diagnosis relies on patients coughing up sputum samples – which can be difficult to obtain from a young child. Even if a sample is obtained, it may not show a lot of TB “bugs” even if the disease is present.
2. Even when diagnosed, cases are not always reported to public health authorities. There are discrepancies between the data methodologies. These factors skew statistics and the imperatives for future programs.
3. In high-burden countries, children get lost under the weight of adult casualties. Dr Welch explains that childhood TB, not just in PNG but worldwide, is often put on the backburner because from a public health perspective the focus is on controlling TB in adults, because it is they who typically spread TB. This is despite, as Dr Welch believes, that children are most affected by the disease.
