In KwaZulu-Natal, where HIV fuels high TB rates among children, diagnosis remains elusive due to vague symptoms like low-grade fevers and swollen glands often mistaken for mumps or pneumonia—leaving only 32% of under-5 contacts receiving preventive treatment amid 26–39% losses to follow-up. New four-month regimens and tools like 3HP offer hope, but adolescents with drug-resistant TB face access barriers, while community stigma, unstable households, and invasive tests like gastric aspiration delay care.
Shepherd’s Keep caregivers stress meticulous daily dosing, nutrition, and isolation protocols to ensure treatment success, urging aggressive intervention without waiting for confirmation in high-risk kids. Scaling school screenings, household controls, and decentralized services is critical to hit 2024–2027 targets and curb this preventable tragedy.
Read more about how Shepherds Keep on the Bluff, cares for their babies.
TB in KwaZulu-Natal: The Reality for Children
Tuberculosis (TB) in children remains a serious public health challenge in KwaZulu-Natal (KZN), especially in communities affected by high HIV rates and poverty.
KZN has one of the highest TB burdens in the world. Studies show high infection rates among young people, while many children go undiagnosed or are diagnosed late. In some areas, families must travel long distances just to access testing and treatment.
In KwaZulu-Natal, where HIV fuels high TB rates among children, diagnosis remains elusive due to vague symptoms like low-grade fevers and swollen glands often mistaken for mumps or pneumonia, leaving only 32% of under-5 contacts receiving preventive treatment amid 26–39% losses to follow-up. New four-month regimens and tools like 3HP offer hope, but adolescents with drug-resistant TB face access barriers, while community stigma, unstable households, and invasive tests like gastric aspiration delay care.
Why children are at risk:
• Children, especially under 5, are more vulnerable to severe TB
• TB symptoms in children are often unclear and easily missed
• Many infections happen at home through close contact with adults
Challenges in diagnosis and treatment:
• TB is difficult to diagnose in children
• Delays in testing can worsen illness and increase spread
• Many children do not complete treatment due to gaps in follow-up
• Drug-resistant TB is harder to treat and less accessible
Efforts to reduce TB in children include:
• Preventive treatment for children exposed to TB
• Shorter, child-friendly treatment regimens
• Routine screening in clinics, schools, and communities
• BCG vaccination at birth to prevent severe TB.
Despite progress, many children are still missed. Barriers such as stigma, lack of awareness, and limited access to services prevent early care.
Early diagnosis, consistent treatment, and community awareness are key to protecting children and ending TB in KZN.
As the world marks World TB Day, OJA shines a spotlight on Shepherd’s Keep and their critical work caring for children affected by TB. Their story will be published in commemoration of the day.
Contact for more information: National Department of Health – TB page with helpline: 0800 012 322,
WhatsApp: 0600 123 456
Website: National Institute for Communicable Diseases www.nicd.ac.za
General Contact Details
Tel: +27 11 386 6400 (Switchboard)