Tuberculosis in Children

The main source of transmission of TB infection to a child is usually an adult with positive tuberculosis in the lungs. TB in children is mainly due to a failure to cure the infectious adult patients. Adults who do not complete their TB treatment put young children below ten years of age at risk to become infected with TB bacilli with a high risk of becoming active tuberculosis.

Reasons why children have a high risk of developing active TB disease:

1. The immune system of young children is less developed than that of an adult and the risk of developing active TB disease is therefore higher in young children. The chance of developing TB disease is greatest shortly after infection. When children present with active tuberculosis disease their family members and other close contacts should be investigated for TB to find the source of the disease and treat them as necessary.

   Therefore a good TB control programme, which will ensure early diagnosis and treatment of adults with infectious form of TB is the best way to prevent TB in children.

2. In HIV infected children the risk is very high to develop TB meningitis with often devastating results for the child like deafness, blindness, paralysis and mental retardation as some of the consequences.

3. Tuberculosis and malnutrition often go together, and a child with TB disease may present as failure to gain weight with loss of energy and a cough lasting for more than three weeks.

The diagnosis of TB in children:

The diagnosis of tuberculosis in children can be difficult because children under the age of 10 years usually cannot cough up sputum to be send for laboratory investigations to confirm the infection of tuberculosis

• The diagnosis depends mainly on the clinical features of cough, weight loss, with a history of close contact with an infectious adult TB patient.
• Special investigations like a skin test and a chest X-ray can be helpful in making the diagnosis of TB in children.

Prevention of TB disease.

1. Early diagnosis and successful treatment of an infectious adult patient is the best way to protect children from becoming infected with TB.

2. BCG immunization of babies soon after birth up to 2 years of age will protect them mainly against the development of TB meningitis.