Tuberculosis disease in children
- Lisa V Adams, MD
Lisa V Adams, MD
- Associate Professor
- Geisel School of Medicine at Dartmouth
- Jeffrey R Starke, MD
Jeffrey R Starke, MD
- Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- C Fordham von Reyn, MD
C Fordham von Reyn, MD
- Section Editor — Tuberculosis; Nontuberculous Mycobacterial Infections
- Professor of Medicine
- Geisel School of Medicine at Dartmouth
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
Formal policies and control efforts addressing tuberculosis (TB) in children have been limited, in part due to lack of a standardized case definition and difficulties associated with establishing a definitive diagnosis . However, since diagnostic and treatment tools for TB in children have begun to improve significantly, TB in children has received increasing attention by researchers, clinicians, and policy makers.
Issues related to TB disease in children will be reviewed here. Issues related to diagnosis and treatment of latent TB infection in children are discussed in detail separately. (See "Latent tuberculosis infection in children".)
Global epidemiology — Estimating the global burden of tuberculosis (TB) disease in children is challenging due to the lack of a standard case definition, the difficulty in establishing a definitive diagnosis, the frequency of extrapulmonary disease in young children, and the relatively low public health priority given to TB in children relative to adults .
The World Health Organization (WHO) publishes global TB data including new and relapse cases by age. In its 2014 report, the WHO estimates that, of the nine million incident cases of TB in 2013, approximately 550,000 occurred among children under age 15 . Additionally, it estimated that there were 80,000 pediatric deaths due to TB (among HIV-uninfected children). Approximately 75 percent of these cases occurred in the 22 highest TB-burden countries (table 1) . In many developing countries, children compose more than one-half of the population, suggesting that the reported cases of childhood TB are likely underestimated.
Children under age five represent an important demographic group for understanding TB epidemiology, since TB frequently progresses rapidly from latent infection to disease, and severe disease manifestations, such as miliary TB and meningitis, are more common in this age group. Therefore, these children serve as sentinel cases, indicating recent and/or ongoing transmission in the community.
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- Global epidemiology
- United States epidemiology
- CLINICAL MANIFESTATIONS
- Pulmonary tuberculosis
- Extrapulmonary tuberculosis
- Perinatal infection
- Adolescent infection
- Screening tests
- - Tuberculin skin test
- - Interferon-gamma release assays
- - Chest radiography
- - Computed tomography scan
- Laboratory studies
- - Acid-fast bacilli smear and culture
- Gastric aspirate
- Other specimens
- - Xpert MTB/RIF and other rapid tests
- Drug resistance
- Investigational diagnostic methods
- Susceptible disease
- Drug-resistant TB
- SUMMARY AND RECOMMENDATIONS