Diagnosis of Childhood Tuberculosis

Abstract

Tuberculosis (TB) in India accounts for about a quarter of the world's TB cases and children are at high risk of tuberculous infection and TB disease. TB diagnosis in children continues to be a challenge due to difficulty in getting appropriate samples and paucibacillary disease. In recently revised recommendations a major emphasis has been made on microbial diagnosis and more liberal use of molecular diagnostic modalities like cartridge-based nucleic acid amplification test (CBNAAT) and line probe assay. Cartridge based nucleic acid amplification test (CB-NAAT, GeneXpert,) is now considered as a World Health Organization (WHO)-recommended rapid diagnostic (WRD ) and is a very simple test ,with a well-established role in the diagnosis of pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) cases in comparison to AFB smear. CBNAAT should be offered upfront whereever TB is suspected. Drug sensitivity tests (DST) should always be attempted in all positive cases. For latent TB infection diagnosis intradermal TST is widely used however interferon-gamma release assays is also an equivalent option.