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Published on: June 6, 2020
[Tuberculosis in children in Romania]
Cristian Didilescu1, Nicoleta Cioran, Domnica Chiotan
1Institutul de Pneumologie Marius Nosto - Progromul Noationalde Control al Tuberculozei, Bucureşti. didilescu@yohoo.com
Insights
Pediatric tuberculosis (TB) is often missed due to diagnostic challenges and limited healthcare access. Romania saw a decrease in childhood TB cases, but severe forms persist, highlighting the need for improved diagnosis and treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Context:
- Tuberculosis (TB) in children is frequently undiagnosed globally, attributed to healthcare access issues and unrecognized symptoms by professionals.
- Romania experienced a decline in overall TB incidence from 2002 to 2011, with a notable reduction in pediatric TB cases (0-14 years).
Purpose:
- To analyze the trends and geographical distribution of pediatric tuberculosis in Romania.
- To highlight the persistent challenges in diagnosing and managing childhood TB, including severe forms.
Summary:
- Childhood TB incidence in Romania decreased from 47.2%ooo in 2002 to 23.6%ooo in 2011.
- Significant county-level variations in pediatric TB incidence were observed, linked to bacillary load and diagnostic deficiencies.
- Severe pediatric TB cases (meningoencephalitis, miliary, cavitary) remained consistently high, indicating the severity of endemic TB.
Impact:
- Emphasizes the critical need for prompt TB diagnosis and effective treatment management in children to reduce disease burden.
- Highlights disparities in pediatric TB detection and diagnosis across Romanian counties.
- Underscores the ongoing severity of endemic tuberculosis in Romania, particularly among the pediatric population.
Abstract:
According to the World Health Organization and Stop TB Partnership, tuberculosis among children often remains undiagnosed, the main reported causes being lack of access to health services or because health professionals unrecognizing the signs and symptoms of tuberculosis in this age group. In Romania, consistent with TB endemic levels, the overall incidence progressively decreased from 142.2%ooo in 2002 to 82.8%ooo in 2011, incidence of TB in children 0-14 years dropped steadily from 47.2 %ooo (1784 cases) in the same "peak year"2002 to 23.6% ooo (766 cases) in 2011. The distribution of TB disease in children by counties shows variations between these, the explanations may be related both to differences in offer of the bacilli between different areas (prevalence of pulmonary patients smear and/or culture positive) and by deficiencies in the detection of cases and lack of rigor in diagnosis (variation in the incidence of TB in 0-14 years from 2.S%ooo in Sălaj county up to 53.2%ooo in Maramures county in 2011). The number of serious cases of TB in children (meningoencephalitis, miliary, cavitary) still maintains a constant high annual rate (65 cases in 2011), which demonstrates the severity of endemic TB in our country. Prompt assurance of TB diagnostic and also the accurate management of TB treatment constitute the guarantee of the decrease of this disease, goal applies to all age groups.
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