Abstract
Adolescents and young adults (AYA, ages 10–24 years) comprise a uniquely important but understudied population in global efforts to end tuberculosis (TB), the leading infectious cause of death by a single agent worldwide prior to the COVID-19 pandemic. While TB prevention and care strategies often overlook AYA by grouping them with either children or adults, AYA have particular physiologic, developmental, and social characteristics that require dedicated approaches. This review describes current evidence on the prevention and control of TB among AYA, including approaches to TB screening, dynamics of TB transmission among AYA, and management challenges within the context of unique developmental needs. Challenges are considered for vulnerable groups of AYA such as migrants and refugees; AYA experiencing homelessness, incarceration, or substance use; and AYA living with HIV. We outline areas for needed research and implementation strategies to address TB among AYA globally.
Highlights
Tuberculosis (TB), the leading infectious cause of death globally by a single agent before the emergence of SARS-CoV-2, continues to challenge prevention and care efforts worldwide
Adolescence encompasses a period of critical change that combines increasing susceptibility to TB with unique developmental and social characteristics to create particular risks for TB transmission, infection, and disease [2,3,4]
As with school-based exposures, the degree of exposure on transit appears to affect the risk of TB transmission, with prolonged close contact associated with higher risk of TB infection than more brief contact [96]
Summary
Tuberculosis (TB), the leading infectious cause of death globally by a single agent before the emergence of SARS-CoV-2, continues to challenge prevention and care efforts worldwide. A recent estimate calculated that 1.8 million adolescents and young adults (AYA, ages 10–24 years) developed TB disease in 2012, representing 17% of all new TB disease diagnoses globally [1]. Adolescence encompasses a period of critical change that combines increasing susceptibility to TB with unique developmental and social characteristics to create particular risks for TB transmission, infection, and disease [2,3,4]. Successful strategies to end TB for all require TB prevention and care approaches that meet adolescents’ needs This narrative review aims to summarize the current knowledge on TB transmission dynamics among AYA, with a focus on needed strategies to address the TB epidemic among. Includes a range of clinical manifestations—which may be pulmonary, extrapulmonary, or both—that develop once infection with M. tuberculosis progresses to invasive disease. We highlight priority areas to strengthen TB prevention, case-finding, and care among AYA
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