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Childhood tuberculosis

Lindsay H Cameron1, Andrea T Cruz1,2

  • 1Department of Pediatrics, Sections of Infectious Diseases.

Current Opinion in Infectious Diseases
|August 10, 2022
PubMed

Insights

Identifying children at risk for tuberculosis requires updated strategies. Recent advancements in interferon gamma release assays (IGRAs) and molecular testing aid diagnosis, while shorter treatment regimens are available but have limitations.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • The management of pediatric tuberculosis (TB) is increasingly complex due to the SARS-CoV-2 pandemic, broader use of immunosuppressants, and evolving treatment protocols.
  • New diagnostic tools and shorter treatment regimens have emerged, but their application requires careful consideration of patient factors and potential drug interactions.

Purpose of the Study:

  • To review the latest literature on identifying children at risk for tuberculosis.
  • To outline optimal testing and treatment strategies for pediatric tuberculosis.
  • To address the challenges posed by the SARS-CoV-2 pandemic and other factors on TB management in children.

Main Methods:

  • Literature review of recent studies on pediatric tuberculosis diagnosis and treatment.
  • Analysis of the impact of SARS-CoV-2 pandemic on global TB control efforts.
  • Evaluation of interferon gamma release assays (IGRAs) and molecular-based tests for TB diagnosis in children.

Main Results:

  • The SARS-CoV-2 pandemic is expected to negatively affect global tuberculosis control.
  • Interferon gamma release assays (IGRAs) and molecular-based testing show promise for improving pediatric TB diagnosis.
  • Shorter, rifamycin-containing treatment regimens are available for pediatric TB infection, but drug-drug interactions limit their use in some immunosuppressed children.

Conclusions:

  • A comprehensive approach to identifying and managing children at risk for tuberculosis is crucial.
  • Enhanced utilization of IGRAs and molecular-based testing is supported by growing evidence for improved pediatric TB diagnosis.
  • Providers must remain aware of the challenges impacting pediatric TB identification and treatment, including pandemic-related disruptions and limitations of shorter treatment regimens in specific populations.
Abstract

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