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Tuberculosis in children: screening, diagnosis and management
Annaleise R Howard-Jones1, Ben J Marais1,2,3
1Department of Infectious Diseases & Microbiology, The Children's Hospital at Westmead, Westmead.
Current Opinion in Pediatrics
|May 7, 2020
Summary
Improving pediatric tuberculosis (TB) screening and management is crucial. Advances in diagnostics and child-friendly treatments offer hope, but implementation challenges remain for effective TB prevention in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Children in TB-endemic regions face a significant disease burden.
- Despite increased awareness, translating this into improved pediatric TB prevention and care remains a challenge.
- Global efforts are needed to address the high incidence of tuberculosis in children.
Purpose of the Study:
- To review recent advancements in the screening, diagnosis, and management of tuberculosis (TB) in children.
- To highlight current challenges and public health priorities in pediatric TB.
- To emphasize the importance of family engagement in TB prevention strategies.
Main Methods:
- Review of recent literature and WHO guidelines on pediatric tuberculosis.
- Analysis of emerging diagnostic tools for noninvasive TB detection in children.
- Assessment of current treatment strategies, including child-friendly formulations.
Main Results:
- New diagnostic tests, including urinary lipoarabinomannan assay and Xpert Ultra on sputum/stool, show promise for pediatric TB detection.
- Child-friendly dispersible fixed-dose combination tablets are available and well-tolerated, improving treatment adherence.
- Implementation of WHO screening guidelines for household contacts of TB cases is limited in high-incidence settings.
Conclusions:
- Effective containment of the global TB epidemic requires high-level government commitment and feasible control strategies.
- Strong engagement between local TB clinics and affected families is essential for preventing secondary TB cases and protecting children.
- Continued research and implementation efforts are vital to overcome challenges in pediatric TB screening, diagnosis, and management.
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