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Childhood tuberculosis
1University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock.
Insights
Pediatric tuberculosis is surging in the US due to socioeconomic factors and immigration. Increased coinfection with HIV and drug-resistant strains demand urgent research and clinical re-education for effective treatment.
Area of Science:
- Public Health
- Pediatric Infectious Diseases
- Epidemiology
Background:
- A concerning rise in pediatric tuberculosis (TB) cases is observed in the United States.
- Factors contributing to this resurgence include poverty, limited healthcare access, and increased immigration from high-TB-prevalence regions.
- Potential coinfection with HIV and *Mycobacterium tuberculosis* (M. tuberculosis) poses a significant threat for a staggering increase in pediatric TB cases.
Purpose of the Study:
- To highlight the alarming increase in pediatric tuberculosis in the United States.
- To emphasize the need for research into the impact of coinfection and drug-resistant TB strains.
- To underscore the necessity for clinicians to update their knowledge on TB diagnosis and treatment in children.
Main Methods:
- This study is a review and analysis of current trends and challenges in pediatric tuberculosis.
- It synthesizes epidemiological data and discusses the impact of socioeconomic factors and coinfections.
- It highlights the need for further basic and clinical research on drug resistance and treatment efficacy.
Main Results:
- Pediatric tuberculosis cases are increasing dramatically in the US.
- Coinfection with HIV and the emergence of multidrug-resistant *M. tuberculosis* strains are critical concerns.
- Current drug availability for effective antitubercular treatment is facing a crisis.
Conclusions:
- The resurgence of pediatric tuberculosis necessitates immediate attention and re-education for healthcare providers.
- Continued research is crucial to address challenges posed by drug-resistant TB and coinfections.
- While eradication remains possible, proactive clinical and research efforts are vital to manage the escalating problem.
Abstract:
The dramatic resurgence and increase in the total number of cases of tuberculous infection and disease in children is alarming in the United States. With poverty, poor access to health care, overcrowding (predominantly in inner-city areas), and an increase in immigration from areas with high endemic rates of tuberculosis, the problem in children will continue to increase. If the impact of coinfection with HIV and M. tuberculosis becomes significant, as it has in adults in the United States, this increase in the total number of cases of tuberculous disease could be staggering. The impact of multiple drug-resistant strains of M. tuberculosis and the current crises in availability of effective antituberculous drugs will need to undergo basic and clinical research. Although the possibility for eradication of M. tuberculosis as a human pathogen in the United States still exists, clinicians must reeducate themselves regarding the epidemiology, pathophysiology, diagnostic work-up, and effective treatment of children with tuberculosis in the current situation of increasing tuberculous disease and resistant organisms in children.