Childhood Tuberculosis

Despite growing international awareness, the tuberculosis (TB) disease burden suffered by young children is underappreciated. This lack of recognition is in part due to difficulties establishing an accurate diagnosis, poor case ascertainment and incomplete reporting.

TB cases are highly concentrated in areas affected by poverty and social disruption, but are increasingly being seen in non-endemic areas due to international travel, population migration and refugee resettlement. TB is now recognized as a major contributor to mortality in children under 5 years old in TB endemic areas. According to conservative World Health Organization (WHO) estimates, greater than 500,000 children developed TB during 2013, and TB disease caused more than 70,000 deaths.

Our research cover a broad range of topics including epidemiological surveillance and disease burden estimates, clinical disease description and treatment options. We also investigate the molecular genetics of the bacterial cause of TB, Mycobacterium tuberculosis, as well as its evolution and spread.

The Childhood Tuberculosis research group is led by Professor Ben Marais.

Current projects

> ‘Connecting the DOTS’ in Vietnam

We are investigating multi-drug resistant TB in a high prevalence setting to inform how to limit spread of this disease

> Tuberculosis transmission within Australia

This NHMRC project grant is investigating the mechanisms and markers of tuberculosis infection in Australia

> Centre of Research Excellence in Tuberculosis Control

This multicentre study is looking at all aspects of TB infection and control: discovery to public health practice and policy

The research team

> Professor Ben Marais, Group Leader, email:

Ben is an Infectious Diseases (ID) specialist at The Children’s Hospital Westmead, deputy-director of the Marie Bashir Institute for Infectious Diseases and Biosecurity and co-leader of the NHMRC Centre for Research Excellence (CRE) in Tuberculosis. Ben has an interest in all infections affecting children and in developing holistic One/Eco Health approaches that considers the well-being of future generations. Please see Ben's University of Sydney profile for more information.  

> Other research team members

  • A/Prof Vitali Sintchenko, Head CIDM Public Health and NSW TB
  • Prof Kristine McCartney, NCIRS BCG immunization
  • Dr. Greg Fox, Research Fellow- Randomized controlled trials in Vietnam
  • Dr. Phil Britton, Research Fellow - National Child TB register project
  • Dr. Alex Outhred, PhD student
  • Ulzii Gurjav, PhD student
  • Members of the TB-CRE

Key publications

Gurjav U, Jelfs P, Hill-Cawthorne GA, Marais BJ, Sintchenko V (2015) Genotype heterogeneity within geospatial hospots suggest foci of imported disease in Sydney, Australia. Infection, Genetics and Evolution [E-pub ahead of print]

Oliwa J, Karumbi J, Marais BJ, Madhi SA, Graham S (2015) Tuberculosis as a cause or comorbidity of childhood pneumonia in tuberculosis-endemic countries: a systematic review. Lancet Resp Med 3: 235-43

Outhred AC, Jelfs P, Suliman B, Hill-Cawthorne GA, Crawford ABH, Marais BJ, Sintchenko V (2015) Added value of whole genome sequencing for management of highly drug resistant tuberculosis. J Antimicrob Chemother [E-pub ahead of print]

Solomons RS, Wessels M, Visser DH, Donald PR, Marais BJ, Schoeman JF, van Furth AM (2014) Uniform research case definition criteria differentiate tuberculous and bacterial meningitis in children. Clin Infect Dis 59: 1574-8

Gurjav U, Jelfs P, Holmes N, Marais BJ, Sintchenko V (2014) Temporal dynamics of prevalent M. tuberculosis genotypes in New South Wales, Australia. BMC Infect Dis 14: 455 (p1-8)

Portevin D, Moukambi F, Clowes P, Bauer A, Chachage M, Ntinginya NE, Mfinanga E, Said K, Haraka F, Rachow A, Saathoff E, Mpina M, Jugheli L, Lwilla F, Marais BJ, Hoelscher M, Daubenberger C, Reither K, Geldmacher C (2014) Performance of the novel TAM-TB assay to diagnose active tuberculosis in children: a prospective, multi-centre study. Lancet Infect Dis 10: 931-8

Graham SM, Sismanidis C, Menzies HJ, Marais BJ, Detjen AK, Black R (2014) Importance of tuberculosis to address child survival. Lancet  383: 1605-7

Britton PN, Yeung V, Lowbridge C, Isaacs D, Marais BJ (2013) Spectrum of disease in children treated for tuberculosis at a tertiary children’s hospital in Australia. J Ped Infect Dis  2: 224-31

Perez-Velez CM, Marais BJ (2012) Tuberculosis in children. N Engl J Med 367: 348-61

Raviglione M, Marais B, Floyd K, Lönnroth K, Getahun H, Migliori GB, Harries AD, Nunn P, Lienhardt C, Graham S, Chakaya J, Weyer K, Cole S, Kaufmann SHE, Zumla A (2012) Scaling up of interventions to achieve global tuberculosis control: progress, new developments and update. Lancet 379: 1902-13