Perspectives of Tuberculosis Management in Pediatric Disease

Despite the lack of attention paid by effective control programs, childhood tuberculosis still remains an important public health problem. Identifying and treating tuberculosis infection and disease in children can also provide long-term benefits to tuberculosis control, preventing future cases due to reactivation. Rates of childhood tuberculosis appear to be rising, particularly in countries with generalized HIV epidemics. Data on childhood tuberculosis treatment outcomes is scarce. Unfortunately, measuring the true burden of childhood tuberculosis in any country is extremely difficult, because no diagnostic test performs well in childhood tuberculosis. Thus, in 25%-50% of childhood tuberculosis the tuberculin skin test may be invariably negative and, hence, much more progress needs to be made in obtaining better and faster diagnostic methods. Thus, perspectives at a management level are briefly described in this chapter in order to provide an update regarding recent advances in diagnosing tuberculosis.