Recognition and management of tuberculosis in children

Abstract 

Tuberculosis is one of the common infectious disease problems in children especially in the developing world. Unlike in adults, diagnosis is difficult. Diagnosis should be based on clinical history, examination, contact history with an adult with contagious tuberculosis, Mantoux tuberculin skin test, appropriate mycobacteriologic and radiographic studies. In view of the rising incidence of drug resistance, bacteriological confirmation and drug susceptibility testing should be sought whenever possible. A 6–8 months intensive course regimen, with three to four drugs in the initial phase, should be used for all forms of uncomplicated pulmonary tuberculosis in children. Longer duration is recommended for severe forms of tuberculosis. During treatment, monitoring for compliance and side effects is mandatory for successful outcome. The role of directly observed therapy is increasingly being recognized and implemented in the control of this disease. Complicated cases such as multi-drug resistant tuberculosis should be managed by specialists in tuberculosis.

Keywords: childhood tuberculosis, Mantoux tuberculin skin test, Mycobacterium tuberculosis, directly observed therapy

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