Diagnosis of Childhood Tuberculosis

Abstract

An estimated 10.4 million incident cases of tuberculosis (TB) occurred globally in 2015, including at least a million cases in children below 15 years of age, while 210,000 children died of TB. About 75% of all childhood TB cases occur every year in the 22 high-burden countries, where childhood cases remain underdiagnosed due to the well-known difficulties with bacteriological confirmation of childhood TB. As such, childhood TB represents a serious threat to global child health and to the WHO End TB Strategy. The development and assessment of accuracy of novel diagnostic tools that could give rapid and reliable diagnosis of childhood TB is hampered by the lack of a perfect reference standard and of standardized case definitions for TB in children. In this article, we discuss the unique immunopathogenesis of TB in children, challenges with the diagnosis of TB in children, and review the utility and accuracy of current WHO-endorsed diagnostics tools for the diagnosis of TB in children. We further discuss future prospects toward the identification of novel biomarkers for pediatric TB detection.