Tuberculosis in children

Abstract

Tuberculosis (TB) in children is a neglected aspect of the TB epidemic despite it constituting 20% or more of all TB cases in many countries with high TB incidence. Childhood TB is a direct consequence of adult TB but remains overshadowed by adult TB because it is usually smear-negative. Infants and young children are more likely to develop life-threatening forms of TB than older children and adults due to their immature immune systems. Therefore, prompt diagnoses are extremely important although difficult since clinical and radiological signs of TB can be non-specific and variable in children. Despite undeniable advances in identifying definite, probable, or possible TB markers, pediatricians still face many problems when diagnosing TB diagnosis. Moreover, curing TB can be difficult when treatment is delayed and when multi-drug resistant (MDR) pathogens are the cause of the disease. In these cases, the prognosis in children is particularly poor because MDR-TB treatment and treatment duration remain unclear. New studies of diagnostic tests and optimal treatment in children are urgently needed with the final goal of developing an effective anti-TB vaccine. Introduction. The impact of tuberculosis (TB) worldwide remains a serious concern with an estimated 8.7 million new cases (13% co-infected with HIV) and 1.4 million deaths due to TB (430,000 in HIV-infected individuals) in 2011. 1 Assessing the impact of TB in children (<15 years of age) is particularly challenging since there is no universal diagnostic algorithm. The identification of TB cases in children usually results from a combination of clinical criteria and a non- specific TB test. In 2011, an estimated 490,000 TB cases occurred among children (about 6% of the all