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Latent TB in Indian pediatric population: An update on evidence gaps and research needs
Suchitra Surve1, Kajal Naukariya1, Ira Shah2
1Child Health Research, Indian Council of Medical Research - National Institute of Research in Reproductive and Child Health (ICMR - NIRRCH), Mumbai, Maharashtra, India.
Insights
This review highlights the critical need for more research on Latent TB Infection (LTBI) in Indian children under five. Current data is scarce, hindering effective diagnosis and management of this significant childhood health issue.
Area of Science:
- Pediatric infectious diseases
- Public health
- Tuberculosis research
Background:
- Latent Tuberculosis Infection (LTBI) is a significant global health concern, particularly in high-burden countries like India.
- Diagnosis, treatment, and management strategies for LTBI in children under five require specific considerations due to limited research.
- Existing data on pediatric LTBI prevalence in India is insufficient, creating a critical knowledge gap.
Purpose of the Study:
- To review existing studies on the diagnosis, treatment, and management of LTBI in children under five within the Indian context.
- To identify research gaps and areas for improvement in pediatric LTBI management.
- To emphasize the need for more data on LTBI prevalence and its impact on young children in India.
Main Methods:
- Comprehensive literature review of online articles and research papers.
- Analysis of current guidelines from the World Health Organization (WHO) and National Tuberculosis Elimination Program (NTEP).
- Synthesis of available data on LTBI prevalence, diagnosis, and management in pediatric populations.
Main Results:
- A significant lack of statistically robust data exists regarding LTBI prevalence in Indian children under five.
- While adult LTBI prevalence in India ranges from 21-48%, pediatric prevalence estimates vary (e.g., ~40% in adolescents, ~22% in under-5s), indicating uncertainty.
- Environmental factors and their influence on childhood LTBI, along with awareness and adverse effects, are under-researched.
Conclusions:
- Urgent research is needed to accurately determine pediatric LTBI prevalence in India, especially in high TB burden areas.
- Current pediatric LTBI management approaches may undervalue the impact of environmental reservoirs.
- Further investigation into awareness, adverse effects, and tailored treatment regimens for childhood LTBI is crucial for effective disease control.
Abstract:
The main aim of this article is to review various studies conducted in relation to diagnosis, treatment and management of Latent TB Infection (LTBI) in under-five children, thus highlighting research gaps and further scope of improvements with respect to Indian context. The methodology involved literature review of various online review articles and research papers along with current published guidelines for LTBI management by World Health Organization (WHO) and National tuberculosis Elimination Program (NTEP). There is a dearth of statistically significant data regarding prevalence of LTBI among under-five children in India. LTBI prevalence in Indian adults has been reported between 21 and 48%. The exact prevalence of pediatric LTBI in India is still not clear, however, as per few studies, the LTBI prevalence ranges around 40% and 22% in adolescent followed by under-5 population. Studies to fill in the research gap of scarcity of prevalence data, regarding pediatric LTBI in high TB burden areas of India, is a pivotal step to curb the global pandemic of TB disease. There is a massive undervaluation of the true burden of childhood LTBI as the influence of environmental reservoir in childhood LTBI and TB are not accounted for in pediatric LTBI regimens. Also, there is no substantiate amount of data that highlights the other aspects of LTBI in pediatric population, like awareness regarding LTBI condition and other physiological adverse effects of LTBI in pediatric population, which have been often observed in under-five children suffering from LTBI.
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