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Published on: August 16, 2021
Infection control and paediatric tuberculosis: A practical guide for the practicing paediatrician
Anne Matlow1, Maryanne Robb, Carol Goldman
1Division of Infectious Diseases, Department of Pediatrics, The Hospital for Sick Children;
Insights
Preventing pediatric tuberculosis (TB) transmission in healthcare settings requires stringent infection control. Maintaining airborne precautions and screening adults are crucial until infectiousness is ruled out.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Healthcare Epidemiology
Background:
- Pediatric tuberculosis (TB) necessitates rigorous infection control measures to prevent nosocomial transmission.
- While children with TB are often less infectious than adults, airborne precautions remain vital until specific risk factors are excluded.
- Screening accompanying adults for TB is essential due to their potential infectiousness.
Purpose of the Study:
- To outline essential infection control strategies for pediatric tuberculosis in healthcare settings.
- To emphasize the importance of airborne precautions and adult screening in preventing TB transmission.
- To highlight key measures for mitigating TB spread within healthcare environments.
Main Methods:
- Review of current guidelines and best practices for TB infection control in pediatric populations.
- Emphasis on administrative controls, engineering solutions, and personal protective equipment (PPE).
- Highlighting the role of clinical suspicion, tuberculin skin testing, and N95 respirator use.
Main Results:
- Maintaining airborne precautions is critical until low-risk status is confirmed.
- Screening adults accompanying pediatric TB patients is a key preventive measure.
- Implementing a multi-faceted approach including administrative, engineering, and personal protective measures is recommended.
Conclusions:
- A high index of clinical suspicion for TB in children with relevant symptoms and risk factors is paramount.
- Comprehensive tuberculin skin test programs and N95 mask usage can significantly reduce transmission risk.
- Adherence to current standards of practice is crucial for preventing TB transmission from pediatric patients with active disease.
Abstract:
Tuberculosis (TB) in children requires close attention to infection control to prevent transmission to other patients and health care workers. Although many children with TB are not infectious, appropriate airborne precautions must be maintained until conditions that increase the risk of transmission have been ruled out and accompanying adults, who may also be infectious, have been screened. Concurrent strategies to prevent TB transmission should be implemented, including administrative, engineering and personal protective measures. The most important measure is maintaining a high clinical index of suspicion for TB in patients with compatible symptoms and epidemiological risk factors. Comprehensive tuberculin skin test programmes and the use of N 95 masks can reduce the risk of transmission within health care settings. Current standards of practice should be followed to prevent transmission from patients with active TB disease.
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