Nearly 8-20% of deaths caused by Tuberculosis (TB) occur in children. Out of all the incident cases (majority of the cases occurring in high TB burdened countries) it is estimated to be 9.6% to 11%. Children can be affected at any age but the most common age is between 1 - 4 years. There is a high risk of developing TB in HIV infected children. It is noticed that tuberculosis and malnutrition often go hand in hand. Usually a child gets infected by an adult with active TB. The common symptoms are cough, fever, night sweats and lose of weight. Diagnosing TB in children can be difficult as children under the age of 10 usually cannot cough up enough sputum to be sent to the lab to confirm the infection of TB. Even chest X-rays are difficult to interpret as the typical shadow is rarely seen. Hence the diagnosis is largely based on the above mentioned symptoms. Coming in close contact with an infectious patient or a positive Tuberculin skin test (TST) is also taken as a confirmation for TB.
Unfortunately very little importance is given to childhood TB resulting in severe consequences. Relatively few studies have been undertaken and children tend to be given the same mg/kg body-weight dosages of antituberculosis drugs as adults. This approach can be called as “one size fits all”. Prevention of childhood tuberculosis can be achieved by the use of the BCG vaccines.
All children who have been diagnosed with TB disease must receive directly observed TB treatment, short-course with the appropriate regimen and must be notified. Once the treatment for TB is started it should be continued until completion.
Nevertheless TB remains an important cause of childhood illness and death. There is a high risk of this disease progressing in young children and are much more likely to develop severe Tuberculosis. There is a real need for prospective epidemiological studies to determine the true burden of TB among children. Without the complete data on the true burden of disease to inform public health policy, childhood TB will remain an essentially invisible and neglected disease.
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