Improving Tuberculosis Care for Children in High-Burden Settings

Starke, Jeffrey R.

doi:10.1542/peds.2014-1652

Cited by 11 publications

(14 citation statements)

References 8 publications

(8 reference statements)

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“…At present, childhood TB is a neglected global health issue 1. While high-resource countries have enjoyed significant reductions in childhood TB over the last number of decades, this has not occurred in low-resource countries.…”

Section: Global Health Problem Analysismentioning

confidence: 99%

Delayed diagnosis of pulmonary tuberculosis in a 13-year-old Malawian boy

Johnston¹,

Sandys

2017

BMJ Case Reports

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Childhood tuberculosis (TB) is a significant global health burden. There are more than 1 million new cases of childhood TB annually. Despite this, many national TB control programs largely focus on identification and treatment of smear positive adults. Early case detection is essential if childhood TB is to be controlled and eradicated.Delayed diagnosis of TB is associated with more advanced disease and worse treatment outcomes. Younger children who go undiagnosed for long periods are at risk of developing severe pulmonary and extrapulmonary disease, such as meningitis. Additionally, advanced childhood TB is a common respiratory cause of death in TB-endemic areas. Undoubtedly, delayed diagnosis contributes significantly to TB-related morbidity and mortality.Diagnostic delay may be divided into patient delay, the duration between development of symptoms and presentation to healthcare provider, and healthcare provider delay, the duration between presentation and initiation of appropriate treatment.

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Section: Global Health Problem Analysismentioning

confidence: 99%

Delayed diagnosis of pulmonary tuberculosis in a 13-year-old Malawian boy

Johnston¹,

Sandys

2017

BMJ Case Reports

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“…), virulence of the infecting organism and the immunology of the child [1, 7–9]. Cases of immunosuppression greatly increase this risk, such as age [1, 10–12], malnutrition [13, 14], diabetes, tobacco and alcohol use, or human immunodeficiency virus (HIV)[15]. As stated before, TB remains a very real threat primarily in third-world countries and is in part due to these risk enhancers.…”

Section: The Global Tuberculosis Epidemic: a Focus On Pediatricsmentioning

confidence: 99%

“…Globally children under the age of 15 accounted for half a million infections in 2011 with 64,000 deaths in HIV negative patients. Children under the age of five are several times more likely than adults to progress to more serious extra pulmonary dissemination involved in miliary TB and TB meningitis [1, 10, 24, 25] and most will succumb to infection within a year of initial exposure [26]. With this rapid progression from infection to disease state, children can be quite indicative of an active epidemic at a local level and are useful in distinguishing between latent and infectious populations.…”

Section: The Global Tuberculosis Epidemic: a Focus On Pediatricsmentioning

confidence: 99%

“…Before 2012, the WHO did not distinguish between pediatric and adult infections when issuing their annual estimate of epidemiology. In addition, the DOTS strategy largely neglects children, as the primary means of detection is sputum smear-positive, which pediatrics often don’t display [10, 14, 24]. Other factors contribute to the delicate disease state of pediatric TB infections including altered immune response [11, 12], difficulties in proper dosing (both amounts and formulation)[34], and the rapid progression to severe disease state.…”

Section: The Global Tuberculosis Epidemic: a Focus On Pediatricsmentioning

confidence: 99%

“…Other conditions common to pediatric populations have a serious effect on the disease burden, including malnourishment, other pulmonary disorders (pneumonia, asthma, etc. ), diabetes and HIV co-infection[10]. …”

Section: The Global Tuberculosis Epidemic: a Focus On Pediatricsmentioning

confidence: 99%

See 2 more Smart Citations

Advances in Drug Discovery and Development for Pediatric Tuberculosis

Hoagland¹,

Zhao²,

Lee

2016

MRMC

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Pediatric tuberculosis is an underappreciated global epidemic estimated to afflict around half a million children worldwide. This problem has historically been overlooked, due in part to their low social status and the difficulty in diagnosis of tuberculosis in children. Children are more susceptible to tuberculosis infection and disease progression, including rapid dissemination into extra-pulmonary infection sites. Treatment of pediatric tuberculosis infections has been traditionally built around agents used to treat the adult disease, but the disease pathology, drug pharmacokinetics and the safety window in children differs from the adult disease. This produces additional concerns for drug discovery and development of new agents. This review examines: (i) the safety concerns for current front and second line agents used to treat complex drug resistant infections and how this knowledge can be used to identify, prioritize and dose agents that may be better tolerated in pediatric populations; (ii) the chemistry and suitability of new drugs in the clinical development pipeline for tuberculosis for the treatment of pediatric infections indicating several new agents may offer significant improvements for the treatment of multi-drug resistant tuberculosis in children.

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Updates in Pediatric Tuberculosis in International Settings

Shakoor

Mir

2022

Pediatric Clinics of North America

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Improving Tuberculosis Care for Children in High-Burden Settings

Cited by 11 publications

References 8 publications

Delayed diagnosis of pulmonary tuberculosis in a 13-year-old Malawian boy

Delayed diagnosis of pulmonary tuberculosis in a 13-year-old Malawian boy

Advances in Drug Discovery and Development for Pediatric Tuberculosis

Updates in Pediatric Tuberculosis in International Settings

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