Latent TB infection in children and adolescents: Scientific rationale and programmatic management

Area of Science:

• Public Health
• Infectious Diseases
• Pediatrics

Background:

• Latent tuberculosis infection (LTBI) is the reservoir for future tuberculosis (TB) cases.
• Children, particularly those under 18, are vulnerable to severe forms of TB, including disseminated disease and TB meningitis.
• Expanding TB preventive therapy is essential for achieving TB elimination goals.

Purpose of the Study:

• To highlight the importance of TB preventive therapy in children and adolescents.
• To discuss the expanded strategies of the national TB elimination program.
• To introduce newer preventive regimens and identify areas for operational research.

Main Methods:

• The study reviews the expanded scope of TB preventive therapy within the national program.
• It discusses the inclusion of new age groups (≥5 years, adolescents) and at-risk populations.
• It mentions the recommendation of newer regimens like weekly isoniazid and rifapentine for three months (3HP).

Main Results:

• The national TB elimination program has broadened its approach to include preventive therapy for a wider demographic.
• Newer, shorter regimens such as 3HP are being incorporated into the program.
• Operational research is needed to address challenges in drug toxicity, resistance, adherence, and treatment completion.

Conclusions:

• TB preventive therapy is a cornerstone of TB elimination strategies, with a critical focus on pediatric and adolescent populations.
• The integration of novel regimens like 3HP offers promising opportunities for improved treatment outcomes.
• Addressing operational challenges through research is vital for the successful implementation and effectiveness of expanded TB preventive therapy programs.