TUBERCULOSIS IN CHILDREN

TB may present at any age in children though the risk is highest below the age of 2 years. When compared to adults,
children are more prone to TB infection, TB disease, and severe forms of TB disease.

Risk factors

  • Contact with infectious (pulmonary) case of TB
  • Age < 5 years
  • Immunosuppression (HIV, malnutrition, diabetes, etc).
  • Age < 1 year and lack of BCG vaccination are risk factors for severe disease

Clinical features

  • Suspect TB in all children with
    • Fever > 2 weeks
    • Cough >2 weeks
    • Poor weight gain for one month
    • Close (home) contact of pulmonary TB case.

Investigations

  • Bacteriological confirmation of TB is more difficult in children. The diagnosis of TB in children is dependent on
    conducting a detailed clinical assessment combined with available tests
  • Whenever possible, geneXpert should be performed
  • TST is a good supportive test for TB diagnosis in children

Management

The principles and objectives of TB treatment are similar to those of adults. In addition, effective treatment of TB in
children promotes growth and development.