Annaleise R Howard-Jones1, Ben J Marais1,2,3. 1. Department of Infectious Diseases & Microbiology, The Children's Hospital at Westmead, Westmead. 2. Discipline of Child and Adolescent Health. 3. Marie Bashir Institute for Infectious Diseases & Biosecurity, University of Sydney, Sydney, New South Wales, Australia.
Abstract
PURPOSE OF REVIEW: The present review focuses on recent advances and current challenges in screening, diagnosis and management of tuberculosis (TB) in children, encompassing TB infection and TB disease, and public health priorities for screening and family engagement. RECENT FINDINGS: Although awareness has improved in recent years that children in TB endemic areas suffer a huge disease burden, translation into better prevention and care remains challenging. Recent WHO guidelines have incorporated screening of all household contacts of pulmonary TB cases, but implementation in high incidence settings remains limited. Improved tests using noninvasive samples, such as the lateral flow urinary lipoarabinomannan assay and the new Xpert Ultra assay applied to induced sputum or stool in young children, are showing promise and further assessment is eagerly awaited. From a treatment perspective, child-friendly dispersible fixed dose combination tablets are now widely available with excellent acceptability and tolerance reported in young children. SUMMARY: High-level government commitment to TB control as a public health priority and feasible strategies to achieve this are required to contain the global epidemic, whereas strong engagement of local TB clinics and affected families in TB prevention is essential to limit secondary cases and protect exposed children.
PURPOSE OF REVIEW: The present review focuses on recent advances and current challenges in screening, diagnosis and management of tuberculosis (TB) in children, encompassing TB infection and TB disease, and public health priorities for screening and family engagement. RECENT FINDINGS: Although awareness has improved in recent years that children in TB endemic areas suffer a huge disease burden, translation into better prevention and care remains challenging. Recent WHO guidelines have incorporated screening of all household contacts of pulmonary TB cases, but implementation in high incidence settings remains limited. Improved tests using noninvasive samples, such as the lateral flow urinary lipoarabinomannan assay and the new Xpert Ultra assay applied to induced sputum or stool in young children, are showing promise and further assessment is eagerly awaited. From a treatment perspective, child-friendly dispersible fixed dose combination tablets are now widely available with excellent acceptability and tolerance reported in young children. SUMMARY: High-level government commitment to TB control as a public health priority and feasible strategies to achieve this are required to contain the global epidemic, whereas strong engagement of local TB clinics and affected families in TB prevention is essential to limit secondary cases and protect exposed children.
Authors: B Joshi; H Font; E Wobudeya; M Nanfuka; A Kobusingye; J Mwanga-Amumpaire; N Natukunda; S Turyahabwe; L Borand; T E Mao; B Dim; R Ferhi; R Moh; J Kouakou; R Aka Bony; G Breton; A Mustapha; L Matata; L Foray; A Detjen; S Verkuijl; M Sekadde; C Khosa; V Mbassa; J-V Taguebue; S Kwedi Nolna; M Bonnet; O Marcy; J Orne-Gliemann Journal: Int J Tuberc Lung Dis Date: 2022-03-01 Impact factor: 3.427
Authors: Shima M Abdulgader; Anna O Okunola; Gcobisa Ndlangalavu; Byron W P Reeve; Brian W Allwood; Coenraad F N Koegelenberg; Rob M Warren; Grant Theron Journal: Respiration Date: 2022-06-27 Impact factor: 3.966