Rano Mal Piryani.
Tuberculosis in children and DOTS.
Pak J Chest Med Jan ;10(1):9-10.

Tuberculosis (TB) kills 2 million people each year in the world, of which 250,000 are children. The basic process of infection and disease caused by Mycobacterium tuberculosis and the concept of diagnosis and management of TB are the same for children and adults. Accurate diagnosis and effective treatment of TB disease are as important for children as for adults. There are several differences in the epidemiology and clinical manifestations of TB in children. Although children and adults are at equal risk to develop TB infection when exposed to a person with a infectious TB, but children are substantially at greater risk of developing TB disease, especially miliary (disseminated) TB and meningitis (involvement of brain coverings). Factors that determine the risk of TB infection are more or less the same for children and adults. The more prolonged and close the exposure to the infectious cases, the greater the risk of infection. Youngest children are much more likely to remain in close and prolonged contact with parents. If the parent/s is/are suffering from active (infectious) pulmonary tuberculosis, there are likely more chances for younger children to get infected with TB germs. Children who develop pulmonary tuberculosis are least likely to have cavitary lesions, thus very unlikely to be sputum smear positive. Most frequently Tuberculosis presents itself as pleurisy among children of 5 years of age or older whereas the youngest children are much more likely to have disseminated disease with meningitis. TB meningitis has a high fatality rate. With BCG vaccination in neonatal period (even in infancy) can undoubtedly reduce this serious form of tuberculosis.

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