title: Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children: An Update.
abstract: Consensus case definitions for childhood tuberculosis have been proposed by an international expert panel, aiming to standardize the reporting of cases in research focusing on the diagnosis of intrathoracic tuberculosis in children. These definitions are intended for tuberculosis diagnostic evaluation studies of symptomatic children with clinical suspicion of intrathoracic tuberculosis, and were not intended to predefine inclusion criteria into such studies. Feedback from researchers suggested that further clarification was required and that these case definitions could be further improved. Particular concerns were the perceived complexity and overlap of some case definitions, as well as the potential exclusion of children with acute onset of symptoms or less severe disease. The updated case definitions proposed here incorporate a number of key changes that aim to reduce complexity and improve research performance, while maintaining the original focus on symptomatic children suspected of having intrathoracic tuberculosis. The changes proposed should enhance harmonized classification for intrathoracic tuberculosis disease in children across studies, resulting in greater comparability and the much-needed ability to pool study results.
authors.affiliation: Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Childrens Research Institute, Royal Children's Hospital, Australia International Union Against Tuberculosis and Lung Disease, Paris, France Burnet Institute, Melbourne, Australia.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Graham
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom.
authors.forename: Luis E
authors.initials: LE
authors.lastname: Cuevas
authors.affiliation: Henry M. Jackson Foundation.
authors.forename: Patrick
authors.initials: P
authors.lastname: Jean-Philippe
authors.affiliation: Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland.
authors.forename: Renee
authors.initials: R
authors.lastname: Browning
authors.affiliation: Médicins Sans Frontières, Geneva, Switzerland.
authors.forename: Martina
authors.initials: M
authors.lastname: Casenghi
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Detjen
authors.affiliation: Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland.
authors.forename: Devasena
authors.initials: D
authors.lastname: Gnanashanmugam
authors.affiliation: Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
authors.forename: Anneke C
authors.initials: AC
authors.lastname: Hesseling
authors.affiliation: Department of Paediatrics, Imperial College London, United Kingdom Vaccinology Theme, MRC Unit, The Gambia.
authors.forename: Beate
authors.initials: B
authors.lastname: Kampmann
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston.
authors.forename: Anna
authors.initials: A
authors.lastname: Mandalakas
authors.affiliation: Marie Bashir Institute for Infectious Diseases and Biosecurity) and the Sydney Emerging Infectious Diseases and Biosecurity Institute and The Children's Hospital at Westmead, Sydney Medical School, University of Sydney, Australia.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Marais
authors.affiliation: Henry M. Jackson Foundation.
authors.forename: Marco
authors.initials: M
authors.lastname: Schito
authors.affiliation: Henry M. Jackson Foundation.
authors.forename: Hans M L
authors.initials: HM
authors.lastname: Spiegel
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Starke
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland.
authors.forename: Carol
authors.initials: C
authors.lastname: Worrell
authors.affiliation: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, MRC Unit on Child and Adolescent Health, University of Cape Town, South Africa.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Zar
mesh_terms: D002648:Child; D002675:Child, Preschool; D032921:Consensus; D006801:Humans; D008297:Male; D012015:Reference Standards; D013909:Thorax; D014376:Tuberculosis / Q000145:classification* / Q000175:diagnosis* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology
keywords: childhood tuberculosis; tuberculosis case definitions; tuberculosis classification; tuberculosis diagnosis