Detection and prevention of tuberculosis in children and adolescents in endemic, resource-limited settings

Project Details

Tuberculosis is an important cause of morbidity and mortality in children and adolescents in tuberculosis-endemic countries, many of which are in the Asia-Pacific region.

There is increasing attention being given to the challenges of childhood tuberculosis, and the World Health Organisation’s post-2015 End TB Strategy provides further opportunity to close the wide current policy-practice gap with a greater focus on children and prevention strategies than previous tuberculosis control strategies.

Since joining the University of Melbourne in 2008, Steve Graham has supervised a number of PhD projects including the evaluation of community-based screening and management of child contacts of tuberculosis cases in Indonesia and the diagnosis of tuberculosis in severely malnourished children in Bangladesh.

He is currently supervising a PhD study on the epidemiology of tuberculosis in adolescents. Steve is also providing technical leadership to projects on community-based case-finding and prevention of child tuberculosis in Viet Nam, Uganda and Myanmar in collaboration with the National Tuberculosis control Programs of those countries.

He is a chief investigator on the NHMRC-funded randomised controlled trial of preventive therapy for close contacts of multi-drug resistant tuberculosis currently being undertaken in Viet Nam, as well as the Centre of Research Excellence on Tuberculosis control.


  • Professor Steve Graham


  • National Health and Medical Research Council (NHMRC)
  • Centre of Research Excellence on Tuberculosis Control

Research Outcomes

  • A mixed-methods evaluation of adherence to preventive treatment among child tuberculosis contacts in Indonesia. Triasih R, Padmawati RS, Duke T, Robertson C, Sawyer SM, Graham SM.  Int J Tuberc Lung Dis 2016; 20: 1078-1083
  • The epidemiology of child tuberculosis in Australia: 2003-2012. Teo SSS, Tay EL, Douglas P, Krause V, Graham SM. Med J Aust 2015; 203: 440
  • An evaluation of chest X-ray in the context of community-based screening of child tuberculosis contacts. Triasih R, Robertson C, de Campo J, Duke T, Choridah L, Graham SM. Int J Tuberc Lung Dis 2015; 19:1428-1434
  • The background and rationale for a new fixed-dose combination for first-line treatment of tuberculosis in children. Graham SM, Grzemska M, Gie RP. Int J Tuberc Lung Dis 2015; 19:S3-S8
  • Clinical case definitions for classification of intrathoracic tuberculosis in children: an update. Graham SM, Cuevas LE, Jean-Philippe P, Browning R, Casenghi M, Detjen AK, Gnanashanmugam D, Hesseling AC, Kampmann B, Mandalakas A, Marais BJ, Schito M, Spiegel HML, Starke JR, Worrell C, Zar HJ. Clin Infect Dis 2015; 61(suppl 3):S179-S187
  • Mycobacteria-specific cytokine responses detect TB infection and distinguish latent from active TB. Tebruegge M, Dutta B, Donath S, Ritz N, Forbes B, Camacho-Badilla K, Clifford V,  Zufferey C, Robins-Browne R, Hanekom W, Graham SM, Connell T, Curtis N. Am J Resp Crit Care Med 2015: 192: 485-492
  • Regional initiatives to address the challenges of tuberculosis in children: perspectives from the Asia-Pacific region. Graham SM, Grzemska M, Brands A, Nguyen H, Amini J, Triasih R, Talukder K, Ahmed S, Amanullah F, Kumar B, Tufail P, Detjen AK, Marais BJ, Hennig C, Islam T. Int J Infect Dis 2015; 32: 166-169
  • Tuberculosis as a cause or comorbidity of childhood pneumonia in tuberculosis endemic settings: a systematic review. Oliwa JN, Karumbi JM, Marais BJ, Madhi SA, Graham SM. Lancet Resp Med 2015; 3: 235-243
  • A prospective evaluation of the symptom-based screening approach to the management of children that are contacts of tuberculosis cases. Triasih R, Duke T, Robertson C, Graham SM. Clin Infect Dis 2015; 60: 12-18
  • Importance of tuberculosis control to address child survival. Graham SM, Sismanidis C, Menzies HJ, Detjen AK, Marais BJ, Black RE. Lancet 2014; 383: 1605-1607
  • A prospective study of the prevalence of tuberculosis and bacteraemia in Bangladeshi children with severe malnutrition and pneumonia including an evaluation of Xpert MTB/RIF assay. Chisti MJ, Graham SM, Duke T, Ahmed T, Faruque ASG, La Vincente S, Banu S, Raqib R, Salam MA. PLoS ONE 2014; 9: e93776
  • The trend of tuberculosis cases in Fiji’s largest treatment centre over 60 years: 1950-2010. Tamani T, Bissell K, Taylor-Smith K, Gounder S, Nguyen L, Graham SM. Public Health Action 2014; 4: 24-26
  • Evaluation of an interferon-gamma release assay in children with suspected tuberculosis in Papua New Guinea. Uluk T, Vince JD, Causer L, Allison W, Graham SM, Wand H, Kaldor J. Pediatr Infect Dis J 2013;32:187-189
  • Preventive therapy in children exposed to Mycobacterium tuberculosis: problems and solutions. Rutherford ME, Hill PC, Triasih R, Sinfield R, van Crevel R, Graham SM. Trop Med Int Health 2012; 17: 1264-1273
  • Long-term follow-up of contacts exposed to multidrug resistant tuberculosis in Victoria, Australia 1995-2010. Denholm JT, Leslie DE, Jenkin GA, Darby J, Johnson PDR Graham SM, Brown GV, Sievers A, Globan M, Brown LK, McBryde ES. Int J Tuberc Lung Dis 2012; 16: 1320-1325
  • Scaling up of interventions to achieve global tuberculosis control: progress, new developments and update 2012. Raviglione M, Marais BJ, Floyd K, Lonnroth K, Getahun H, Migliori GB, Harries AD, Nunn P, Leinhardt C, Graham SM, Chakaya J, Weyer K, Cole S, Kaufmann SHE, Zumla A. Lancet 2012; 379: 1902-1913
  • Childhood tuberculosis: progress requires advocacy strategy now. Sandgren A, Cuevas LE, Dara M, Gie RP, Grzemska M, Hawkridge A, Hesseling AC, Kampmann B, Lienhardt C, Manissero D, Wingfield C, Graham SM. Eur Resp J 2012; 40: 294-297
  • Xpert® MTB/RIF for national tuberculosis programmes in low-income countries: when, where and how? Tr√©bucq A, Enarson D A, Chiang C Y, Van Deun A, Harries A D, Boillot F, Detjen A, Fujiwara P I, Graham SM, Monedero I, Rusen I D, Rieder H L. Int J Tuberc Lung Dis 2011; 15: 1567-1572
  • Closing the policy-practice gap in the management of child contacts of tuberculosis cases in developing countries. Hill PC, Rutherford ME, Audas R, van Crevel R, Graham SM. PLoS Med 2011; 8: e1001105.
  • Scale-up of services and research priorities for diagnosis, management, and control of tuberculosis. Marais BJ, Raviglione M, Donald PR, Harries AD, Kritski AL, Graham SM, El-Sadr WM, Harrington M, Churchyard G, Mwaba P, Sanne I, Kaufmann SHE, Whitty CJM, Atun R, Zumla A. Lancet 2010; 375; 105-117

Research Group

Centre for International Child Health

Faculty Research Themes

Infection and Immunology, Child Health

School Research Themes

Child Health in Medicine

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre


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