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A 3D Human Lung Tissue Model for Functional Studies on Mycobacterium tuberculosis Infection
Published on: October 5, 2015
Tuberculosis - persistent threat to human health
1Jaslok Hospital and Medical Research Center, Mumbai, Maharashtra, India. ykakr@vsnl.com.
Insights
Childhood tuberculosis requires urgent attention, as infections acquired in childhood can lead to adult disease and transmission. Effective control hinges on early detection and ensuring treatment compliance for pediatric tuberculosis cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Childhood tuberculosis constitutes 40% of global cases, highlighting its significant public health impact.
- Increasing evidence suggests childhood infections are a crucial source for adult tuberculosis reactivation and transmission.
- Current tuberculosis (TB) control strategies may be insufficient due to the unique challenges of pediatric cases.
Purpose of the Study:
- To emphasize the critical need for increased focus on childhood tuberculosis control.
- To highlight diagnostic challenges and the importance of early detection and treatment compliance in children.
- To discuss the limitations of current diagnostic methods and the role of direct observed treatment (DOTS).
Main Methods:
- Review of current understanding of childhood tuberculosis epidemiology and transmission dynamics.
- Analysis of diagnostic difficulties, including limited bacteriological confirmation and non-specific clinical presentations.
- Evaluation of treatment compliance issues and the recommended strategy of direct observed treatment (DOTS).
Main Results:
- Childhood tuberculosis is a significant driver of ongoing TB transmission, necessitating greater attention.
- Diagnosis is challenging due to low bacillary load, inaccessible sites, and variable clinical signs.
- Poor treatment compliance remains a major barrier to effective TB control and contributes to drug resistance.
Conclusions:
- Childhood tuberculosis demands equal or greater attention than adult cases for effective global TB control.
- Improving early detection through simple tests and ensuring treatment compliance are paramount goals.
- Addressing misconceptions and enhancing accountability in TB management are essential for continued success.
Abstract:
With the increasing incidence of tuberculosis worldwide, childhood cases now constitute 40% of the total. TB control thus has global importance. Unfortunately, control of disease is not in sight. It was always thought that adult tuberculosis is the fountainhead of childhood tuberculosis but it is being increasingly realized that it is the infection acquired during childhood that promotes reactivation of adult disease, which in turn maintains the chain of transmission.Thus childhood tuberculosis needs equal or more attention for effective control. Early detection by simple tests and ensuring treatment compliance is the goal. The small number of bacilli and inaccessible sites for bacteriological confirmation makes diagnosis of childhood tuberculosis difficult. Circumstantial evidence is often the basis of diagnosis. However, as clinical manifestations depend upon host immune response and virulence of tubercle bacilli, there is no typical clinical presentation. A large number of infected children may remain asymptomatic, undiagnosed and untreated. Conventional tests such as tuberculin test and radiology are not fully dependable and newer tests have limitations. Poor patient treatment compliance contributes to failure of a tuberculosis control program and leads to drug resistance. To combat this, direct observed treatment (DOTS) has been unanimously recommended in treatment of tuberculosis. DOTS is however estimated to be used in less than 40% of new cases. Misconceptions threaten to undermine continued success in tuberculosis control. TB control is essentially a management problem. Greater accountability of governments, donors and providers is essential.
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