How innovations in TB detection are transforming pediatric care in Bangladesh

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Rukaya, three-and-a-half years old, hadn't been feeling well for the last couple of months. She had a stubborn fever that didn’t improve after taking medicine prescribed by her doctor, and her high temperature had been back for the last 15 days, explained her father, Gulzar Hossain.

“It was strange but I wasn’t too concerned,” he told Devex as a health worker took Rukaya’s medical history in the Integrated Management of Childhood Illness corner in Narsingdi Sadar Hospital, about 40 kilometers (29 miles) outside Dhaka, Bangladesh.

The IMCI health worker believed Rukaya could be at risk for tuberculosis, a disease that killed an estimated 139,000 children under five worldwide in 2022. The results from a Tuberculin skin test, or TST, indicated that indeed she was a presumptive tuberculosis patient. “I didn’t think it could have been tuberculosis. I’ve never had experience with it,” said Farida Parvin, Rukaya’s mother, before whisking Rukaya off to receive a chest X-ray. “But I feel relieved to be here and have the tests done. If it’s tuberculosis, we’ll follow the procedure.”

What appeared to be a routine intervention that caught a potentially deadly disease may not have taken place just a few years ago, when IMCI staff weren’t trained to see Rukaya’s history and symptoms as indicative of a possible tuberculosis diagnosis.

But in recent years, there’s been a major push to train IMCI staff members in identifying potential TB cases, led by national health authorities alongside local and international organizations including the International Centre for Diarrhoeal Disease Research, Bangladesh (icddbr,b), the Stop TB Partnership, and The Global Fund to Fight AIDS, Tuberculosis and Malaria.  This, coupled with the deployment of a plethora of innovative diagnostic and treatment tools such as mobile X-ray units installed with artificial intelligence software, has resulted in significant gains in the fight to stop TB in high-burden countries such as Bangladesh.

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