{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:20:35Z","timestamp":1792704035615,"version":"4.5.0"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"\n \n <\/jats:sec>\n \n BACKGROUND<\/jats:title>\n Pediatric tuberculosis (TB) remains a major public health concern in high-burden settings like the Western Cape (WC), South Africa. We analyzed geographic differences in TB burden among children and young adolescents, described temporal trends, and quantified gaps in the TB care cascade.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n We conducted a population-based descriptive study of pediatric TB episodes recorded in the Provincial Health Data Centre (PHDC) from 2017 to 2023, stratified by 5-year age groups. We assessed HIV status, drug resistance status, microbiological testing, disease classification, place of diagnosis, and TB treatment outcomes. Reporting gaps were estimated by comparing PHDC-recorded episodes with national notifications. Incidence rates of diagnosis were calculated using mid-year population estimates.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n In 2023, TB incidence rates of diagnosis in the WC were 722.4, 189.1, and 171.2 per 100\u2009000 population for ages 0 to 4, 5 to 9, and 10 to 14\u00a0years. Children aged 0 to 4\u00a0years accounted for 68.9% of pediatric TB episodes. In the Cape Winelands district in 2023, TB incidence of diagnosis among 0- to 4-year-olds was double that of adults in the district and 2 to 4 times higher than 0- to 4-year-olds in other districts. We found high levels of underreporting (20.6%) and initial loss to follow-up (17.9%) among children and young adolescents diagnosed with TB between 2017 and 2023.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Our findings highlight geographic variation in pediatric TB burden in the WC, emphasizing the need to address local drivers to inform targeted interventions. Gaps in the pediatric TB care cascade remain major concerns. Strengthening integrated data systems beyond TB treatment registers could improve surveillance, health system planning, and patient outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2025-072223","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:03:07Z","timestamp":1767744187000},"source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology of Pediatric Tuberculosis in the Western Cape: A Population-Based Study (2017\u20132023)"],"prefix":"10.1542","volume":"157","author":[{"given":"Lauren R.","family":"Brown","sequence":"first","affiliation":[{"name":"1South African Centre for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariette","family":"Smith","sequence":"additional","affiliation":[{"name":"2Provincial Health Data Centre, Western Cape Department of Health, Cape Town, South Africa"},{"name":"3Centre for Integrated Data and Epidemiological Research, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cari","family":"van Schalkwyk","sequence":"additional","affiliation":[{"name":"1South African Centre for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh F.","family":"Johnson","sequence":"additional","affiliation":[{"name":"3Centre for Integrated Data and Epidemiological Research, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Mudaly","sequence":"additional","affiliation":[{"name":"4Department of Health and Wellness, Provincial Government of the Western Cape, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Mohr-Holland","sequence":"additional","affiliation":[{"name":"5City of Cape Town Health Department, Specialised Health, Epidemiology Unit, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Simon","family":"Schaaf","sequence":"additional","affiliation":[{"name":"6Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Seddon","sequence":"additional","affiliation":[{"name":"6Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa"},{"name":"7Department of Infectious Disease, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneke C.","family":"Hesseling","sequence":"additional","affiliation":[{"name":"6Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Nuttall","sequence":"additional","affiliation":[{"name":"8Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Rabie","sequence":"additional","affiliation":[{"name":"9Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary-Ann","family":"Davies","sequence":"additional","affiliation":[{"name":"3Centre for Integrated Data and Epidemiological Research, University of Cape Town, Cape Town, South Africa"},{"name":"4Department of Health and Wellness, Provincial Government of the Western Cape, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Boulle","sequence":"additional","affiliation":[{"name":"2Provincial Health Data Centre, Western Cape Department of Health, Cape Town, South Africa"},{"name":"3Centre for Integrated Data and Epidemiological Research, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"du Preez","sequence":"additional","affiliation":[{"name":"6Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"2026033105173423700_r1","article-title":"2024 Global Tuberculosis Report","author":"World Health Organization"},{"issue":"8","key":"2026033105173423700_r2","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/S1473-3099(08)70182-8","article-title":"Paediatric tuberculosis","volume":"8","author":"Newton","year":"2008","journal-title":"Lancet Infect Dis."},{"issue":"1","key":"2026033105173423700_r3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s41479-016-0023-9","article-title":"Tuberculosis exposure, infection 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treatment outcomes in the Western Cape","volume":"21","author":"Snow","year":"2017","journal-title":"Int J Tuberc Lung Dis."},{"issue":"2","key":"2026033105173423700_r7","first-page":"1143","article-title":"Data centre profile: the provincial health data centre of the Western Cape Province, South Africa","volume":"4","author":"Boulle","year":"2019","journal-title":"Int J Popul Data Sci."},{"issue":"1","key":"2026033105173423700_r8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5588\/pha.11.0010","article-title":"Incomplete registration and reporting of culture-confirmed childhood tuberculosis diagnosed in hospital","volume":"1","author":"du Preez","year":"2011","journal-title":"Public Health Action."},{"issue":"3","key":"2026033105173423700_r9","first-page":"259","article-title":"The burden of childhood tuberculosis and the accuracy of community-based surveillance data","volume":"10","author":"Marais","year":"2006","journal-title":"Int J Tuberc Lung 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systematic review and meta-analysis","volume":"29","author":"Seid","year":"2022","journal-title":"J Clin Tuberc Other Mycobact Dis."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-072223\/1905450\/pediatrics.2025072223.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-072223\/1905450\/pediatrics.2025072223.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:17:41Z","timestamp":1774948661000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/157\/2\/e2025072223\/206055\/Epidemiology-of-Pediatric-Tuberculosis-in-the"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,7]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1,7]]},"published-print":{"date-parts":[[2026,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2025-072223","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,7]]},"article-number":"e2025072223"}}