The hunt for childhood tuberculosis

Meera Senthilingam, for CNN

Updated 7:50 AM ET, Tue March 24, 2015
Ugandan child with TBUgandan child with TB
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Six-year-old Bukenya Hethiri, began coughing at the age of two. It took three years to diagnose him with tuberculosis (TB), due to the challenges of diagnosing TB in children. Meera Senthilingam/CNN
There are more than 1,000 private healthcare clinics in Kampala, which are the first port of call for more than 50% of the population. But until now, they had limited skills and resources to diagnose TB. © Will Boase/The Union
The urban slums of Kampala, Uganda have high rates of TB, with confined environments and poor ventilation helping to spread the disease. Healthcare services often fail to diagnose children with TB. © Will Boase/The Union
Hethiri and his mother live in a small room in a slum in the Kawempe division of Kampala. He was finally diagnosed with TB thanks to the help of a local village health worker who was part of the city's SPARK-TB program. © Will Boase/The Union
Children are estimated to contribute to between 12-20% of the 60,000 total TB cases notified each year in Uganda. SPARK-TB has provided private clinics with the skills and services to more readily spot and diagnose TB first in adults, and now children. Meera Senthilingam/CNN
More than 200 clinics in Kampala and its surrounding districts are supported by SPARK TBPlus, including the Doctors medicare clinic, where sputum induction machines have been provided to collect higher quality samples from children. Meera Senthilingam/CNN
Sputum induction involves the use of a nebulizer and tubing to stimulate sputum production within a child's larynx to then suck it up for sampling. Meera Senthilingam/CNN
The main method of diagnosing TB is by testing samples of mucus -- known as sputum -- coughed up by patients suspected to be infected. Even when children are able to produce samples, detection of TB bacteria within the sample remains difficult due to low numbers present in the sample. © Will Boase/The Union
As part of the SPARK TB program there are monthly health camps in each of the city's administrative divisions, often located within public spaces such as markets.
Village health teams help spread information about the signs and symptoms of TB for to help people come forward for testing. Those who do come forward are logged to ensure they received their test results. © Will Boase/The Union