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Free Content Tuberculosis in children: reassessing the need for improved diagnosis in global control strategies

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Pediatric pulmonary tuberculosis (PPTB) remains a major cause of morbidity and mortality worldwide, particularly in less developed countries. Current techniques are inadequate for diagnosing PPTB. This is an impediment not only for the diagnosis and treatment of PPTB cases, but also for epidemiological investigations assessing PPTB burden and disease transmission. Causes of misdiagnosis of PPTB include non-specific signs/symptoms, low bacillary load, recovery methods (sputum or gastric aspirate) for obtaining a clinical sample with low bacillary yield, and the inherent low sensitivities of the diagnostic tests themselves. New diagnostic and recovery methods have recently been evaluated which may provide a means of overcoming some of these obstacles. Unfortunately, progress in developing and implementing improved diagnostic tests for PPTB has been partially impeded by the very low priority of PPTB in global TB control programs based on cost-effective strategies. Regardless of the cost-effectiveness of diagnosing and treating PPTB, our moral obligation to provide access to health care demands that we evaluate and deal with this neglected group of patients. Furthermore, recent evidence indicates that PPTB may actually be responsible for more disease transmission than previously thought. In this review, we present compelling evidence that research agendas and TB control programs should be reassessed and possibly revised to deal with the global disease caused by PPTB.
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Keywords: children; diagnosis; policy; transmission; tuberculosis

Document Type: Review Article

Affiliations: Centro Internacional de Entrenamiento e Investigaciones M├ędicas (CIDEIM), Cali, Colombia

Publication date: July 1, 2001

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

    Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.

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