Prevention of tuberculosis in children: missed opportunities

We conducted an eight-year prospective investigation in Tennessee of all cases of tuberculosis (TB) reported statewide in children younger than 15 years of age. Of the 109 verified childhood cases reported from 1981 to 1988, at least 23 (21%) were preventable. Eleven children developed the disease while they were under surveillance but were not receiving preventive therapy, nine cases resulted from failure of health care providers to conduct timely contact interviews/investigations, and three were due to other reasons. Improved surveillance, increased use of preventive therapy, and ensured compliance will contribute significantly to the elimination of tuberculosis in children at high risk of developing the disease.