According to the World Health Organization, TB is one of the ten most frequent causes of death among children under five years of age. The main challenge remains the correct and timely diagnosis of TB, especially in resource-constrained settings. TB is more difficult to diagnose in children compared to adults because there are far fewer TB bacteria present. Diagnosis of TB in children with HIV infection is even more difficult and they are more likely to develop TB compared to children not infected with HIV.

To test young children for TB, the collection of mucus from the lungs (sputum) or liquid contents of the stomach are required but these procedures are often not available in settings with a high TB burden. Despite advances in TB diagnostic tests in the last decade, these have not impacted significantly on paediatric TB. This means that in many children the diagnosis of TB is still missed. New and innovative approaches to diagnosis TB in children are therefore urgently needed.

The Oxford Vaccine Group has been conducting clinical trials around the globe to address this major challenge. Studies to identify novel and better diagnostic tests and testing approaches for TB are being undertaken in several Sub-Saharan African countries, South America, India and in the Arctic.