Adolescents and young adults: a neglected population group for tuberculosis surveillance

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Tuberculosis (TB) remains a serious public health concern and it is considered the leading infectious cause of death globally. The World Health Organization (WHO) Global Tuberculosis Report of 2017 showed an estimated 10.4 million new TB cases for 2016, of which 6.7 million (64.4%) were males and 1.04 million (10%) were children 0–14 years of age [1]. Unfortunately, these figures represent estimates, an attempt to quantify the real number of TB cases, since the notifications provided from many national surveillance systems, including some of the high-burden TB countries, fail to capture many TB cases. This is either because TB cases are not diagnosed or not recorded and reported to the health authorities. In fact, the WHO estimates that only 61% of all TB cases are notified to national health authorities [1]. Other available global estimates using a different methodology, such as those by the Institute for Health Metrics and Evaluation (IHME), derived from the Global Burden of Disease project, present a similar diagnostic gap of at least one-third of the cases [2]. Trying to close this gap between real and diagnosed/reported cases (those who are likely to receive adequate treatment) with active case-finding strategies has been the target of many TB control efforts, with different levels of success [2]. The premise is clear: undiagnosed cases have much higher mortality and perpetuate the spread of the disease within communities [3, 4].