Childhood tuberculosis in the United States: shifting the focus to prevention.

In the last century, the United States has transitioned from a high to a low tuberculosis (TB) incidence country. A major factor in this decline has been the emphasis on identification and treatment of patients with tuberculous infection. While identification, testing, and preventive therapy pose challenges, recent developments in childhood TB offer more options for effective strategies that are acceptable to both children and their families. These include screening and testing in non-traditional settings, use of more specific assays (interferon-gamma release assays) for testing, and implementation of shorter-course preventive regimens.