Management of tuberculosis in children in low-income countries [Child Lung Health. Serialised guide. Management of the child with cough or difficult breathing. Number 6 in the series]

• Published in: The international journal of tuberculosis and lung disease Vol. 9; no. 12; pp. 1299 - 1304
• Main Authors: ENARSON, P. M, ENARSON, D. A, GIE, R
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.12.2005; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Antitubercular Agents - administration & dosage; Bacterial diseases; BCG Vaccine; Biological and medical sciences; Child, Preschool; Developing Countries; Diagnosis; Directly Observed Therapy; Human bacterial diseases; Human immunodeficiency virus; Humans; Infant; Infant, Newborn; Infectious diseases; Medical sciences; Miscellaneous; Monitoring; Pneumology; Practice Guidelines as Topic; Prevention and actions; Preventive Treatment; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiratory system : syndromes and miscellaneous diseases; Treatment Regimens; Tuberculosis - diagnosis; Tuberculosis - therapy; Tuberculosis - transmission; Tuberculosis and atypical mycobacterial infections; Vaccination; Human; Respiratory disease; preventive treatment; Vaccination; Developing countries; Mycobacterial infection; Infection; Prevention; Immunoprophylaxis; Treatment; Tuberculosis; Surveillance; Bacteriosis; Diagnosis; treatment regimens; Child; Monitoring
• ISSN: 1027-3719; 1815-7920

Children become infected when they are exposed to infectious adults with smear-positive tuberculosis (TB). Most children become infected, but few progress to disease (TB). Children at greatest risk of developing disease are those younger than 5 years of age, HIV-infected and severely malnourished. TB is diagnosed in a child when the child has been exposed to an infectious case, has symptoms and a radiological picture suggestive of TB. Children are treated by the DOTS strategy, and can be treated with 6- or 8-month regimens. HIV-infected children are treated with the same regimens. Children under 5 years of age exposed to an infectious case or infected with TB (tuberculin skin test positive) who are asymptomatic must receive preventive chemotherapy (isoniazid for 6 months). Babies born to mothers with active TB must be managed carefully, as they could have congenital TB, and if they do not have TB they will need preventive chemotherapy for 6 months. BCG is indicated in all children soon after birth, except for those with symptomatic HIV infection. The main aim of any TB programme is to prevent the spread of TB, and also the spread to children, which is best achieved by early detection and treatment of adults with smear-positive TB.