What's in a number? Accurate estimates of childhood tuberculosis

There is growing recognition that children bear a substantial burden of tuberculosis morbidity and mortality. However, in regions where the diagnosis is contingent on smear microscopy, the burden attributable to children, who usually have paucibacillary disease, is grossly underestimated. The downstream ramifications of inaccurate estimates include inadequate attention and funding for childhood tuberculosis surveillance, diagnosis, treatment, prevention, and research. In the absence of microbiologically based diagnoses, estimates of tuberculosis in children have been based on extrapolation from adult data.