Closing the diagnostic gap for children with tuberculosis
Every year, an estimated 1.25 million children develop tuberculosis — yet more than half are never diagnosed or reported.
The diagnostic gap
More than half of children with TB are never diagnosed.
Illustration of “more than half”: each dot stands for one in a hundred children.
1.25M
children develop tuberculosis every year (estimated).
96%
of the children who die of TB were never treated.
Why diagnosing young children is so hard
- They rarely produce enough sputum for standard microbiological tests.
- Their symptoms overlap with common childhood illnesses.
- Existing confirmatory microbiological tests lack sensitivity in this age group.
The solution
Three innovations, one bedside decision.
ACT4KIDS-TB stands for Actiphage®-supported Clinical Tools for Knowledge-driven Innovations in Diagnostic Solutions for TB in young children. The three tools are developed and tested together in children with presumptive TB in Benin and South Africa.
01 · Clinical decision-making
CDM-app
An open-access bedside app that helps health care workers, from community level to specialists, decide whether to treat, test or reassure, informed by the clinical action threshold(s).
02 · Blood-based test
Actiphage®
A blood test that confirms live TB bacteria without the need for a respiratory sample, with results in days compared to weeks for culture.
03 · Computer-aided detection
CAD for chest X-rays
Certified software that reads chest X-rays, validated for children and brought to the point of care using phone-based images of chest X-rays.
Time to result
Schematic comparison, not to scale.
4
years of research, from August 2026 to July 2030
200+
children’s chest X-rays in a new paediatric repository, from Benin and South Africa
6
partner institutions in four countries
3
levels of training for health care workers: national, regional and international
Schematic, not a map.
The consortium
Coordinated from Antwerp and South Africa, delivered in Africa.
Coordinated by the Institute of Tropical Medicine (ITM) in Belgium and Stellenbosch University in South Africa, ACT4KIDS-TB brings together six institutions in Belgium, Benin, Kenya and South Africa. The trials take place in Cotonou (Benin) and Cape Town (South Africa).
Five work packages, one pathway.
WP1
Actiphage® trial
WP2
Decision app (CDM)
WP3
Cost-effectiveness, acceptability, feasibility
WP4
Chest X-ray reading (CAD) at the point of care
WP5
Communication, training, capacity