Childhood tuberculosis--risk assessment and diagnosis
Marais, B.J.
South African Medical Journal 97(10 Pt 2): 978-982
2007
ISSN/ISBN: 0256-9574 PMID: 18000584 Document Number: 204747
There is increased awareness of the severe tuberculosis (TB)-related morbidity and mortality suffered by children in TB-endemic countries. Access to accurate diagnosis and effective treatment in TB-endemic countries has been facilitated by recent landmark developments. The World Health Organization (WHO) published guidelines for national TB programmes on the management of TB in children,(1) and the Global Drug Facility (GDF) made child-friendly drug formulations available for the first time. However, establishing an accurate TB diagnosis in children, particularly in TB-endemic settings that carry the brunt of the TB disease burden, remains a tenacious problem.Robert Koch proved that TB was a transmissible disease caused by Mycobacterium tuberculosis. However, it was soon recognised that only a small minority of people infected with M. tuberculosis ever progress to active disease. This explains why the diagnostic challenge is more pronounced in TB-endemic countries where TB infection is exceedingly common, which increases the need to differentiate between latent TB infection (LTBI) and active disease.