Tuberculosis infection in children: need to strengthen and intensify control efforts.

Yadav, et al. [1] reported the annual risk of tuberculosis infection (ARTI) of 1.2-1.6% and infection prevalence of 6.3-8.2% in tribal children <10 years in Madhya Pradesh. These metrics are similar to those in other tribal populations and in general populations throughout India [1]. They conclude stating: “there is need to strengthen and further intensify TB control measures in the area,” implying that current measures are failing. Other recent papers also have illustrated the failure of TB control in spite of long-standing efforts of the Ministry of Health [2,3]. National TB Control Programme (NTCP), started in 1962, was evaluated in 1990-92 and found to have failed [4,5]. The Revised NTCP (RNTCP) was launched in 1992-93 [4,5]. Control status requires reduction of cumulative infection prevalence to <1 in children by 14 years of age and ARTI of ~ 0.07% [3-5]. However, ARTI remains >1% over decades; infection prevalence in orders of magnitude higher than desired [1-4]. Nationally, there is no decline in incidence or prevalence of TB in adults [5].