TB in developing countries: diagnosis and treatment

Childhood tuberculosis poses great challenges to the public health manager as well as the pediatrician. While mycobacterial detection and isolation remain the gold standard but has a poor sensitivity for several reasons. The diagnosis of the disease is often based on indirect methods like PPD positivity, radiological features and history of contact. Serology and PCR based diagnostic methods have failed to help a clinician working at the peripheral level. The review shares and discusses the place of the various tests in the diagnosis of tuberculosis. WHO has been propagating the use of intermittent supervised treatment for all cases including children. We discuss the concerns of the pediatricians and share our experience on this therapy.