An update on primary care management for tuberculosis in children.
OBJECTIVE
Tuberculosis (TB) is still a significant cause of mortality and morbidity among children worldwide. Recent advances in scientific and clinical research have looked into the epidemiology, diagnostic, therapeutic and preventive interventions in order to provide insights into more effective control.


RESULTS
The risk of infection has been shown to be related to the duration and proximity of exposure to an infectious case, usually an adult or adolescent, rising with increased exposure in toddlers, associated with school entry, and in the teen years and early adulthood. Initial primary exposure to TB disease plays a significant role in the development of a latent TB infection, which may serve as a reservoir for future reactivation in adulthood. Diagnosis remains a dilemma for the clinician due to the lack of a gold standard. T-cell assays measuring production of interferon gamma have proven to be more specific than the Tuberculin Skin Test but are unable to distinguish between latent and active disease.


CONCLUSIONS
Recent findings have shown the importance of addressing not only active TB disease in children but also latent TB infection. Advances in understanding TB in children provide insights to enhance efforts to control this disease.
Sablan
Benjamin
B
Pediatrics Department, College of Medicine, University of the Philippines, Manila, Philippines. bpsablanjr@yahoo.com
D000293:Adolescent; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011320:Primary Health Care / Q000379:methods*; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D032581:Tuberculosis Vaccines / Q000627:therapeutic use
D000904:Antibiotics, Antitubercular; D032581:Tuberculosis Vaccines