Infection control and paediatric tuberculosis: A practical guide for the practicing paediatrician

Abstract

Tuberculosis (TB) in children requires close attention to infection control to prevent transmission to other patients and health care workers. Although many children with TB are not infectious, appropriate airborne precautions must be maintained until conditions that increase the risk of transmission have been ruled out and accompanying adults, who may also be infectious, have been screened. Concurrent strategies to prevent TB transmission should be implemented, including administrative, engineering and personal protective measures. The most important measure is maintaining a high clinical index of suspicion for TB in patients with compatible symptoms and epidemiological risk factors. Comprehensive tuberculin skin test programmes and the use of N 95 masks can reduce the risk of transmission within health care settings. Current standards of practice should be followed to prevent transmission from patients with active TB disease.

Indications to Hospital Admission and Isolation of Children With Possible or Defined Tuberculosis

“…40 However, various studies (mainly carried out in the USA) reported a suboptimal compliance with these indications, without any substantial increase in nosocomial transmission. 41 – 44 …”

Treatment of drug-resistant tuberculosis in children and young adolescents in Brazil

“…A large proportion of cases are concentrated in young adolescents, aged 10–14 years, who are more easily diagnosed and have an increased risk of exposure to TB [7] , [27] . In this group, the disease generally presents more like that of adults, is more often infectious, and is a major source of transmission [28] . In addition, adolescents are vulnerable and prone to challenges in follow-up and treatment adherence, reinforcing the importance of additional counseling for this age group [6] .…”

Emerging Public Health Issues in Drug-Resistant Tuberculosis

“…This aims to prevent transmission from cases to other patients or health care workers. The following means could help to ensure the protection of health care staff: Use of N95 mask by all staff on medical and TB isolation wards and in the HIV clinics [53]; HIV testing of all staff with reallocation of those testing positive to lower-risk positions; Annual Chest Xray screening for TB for all staff [24,54].…”