Treatment of tuberculosis infection in children

Abstract

Identifying and treating children with tuberculosis (TB) infection in both low and high-TB burden settings will decrease the incidence of TB disease worldwide. Areas covered: This review covers each of the available TB infection treatment options for children based on effectiveness, safety, tolerability and treatment completion rates. Six to 9 months of daily administered isoniazid is no longer the treatment of choice for many children with TB infection. Shorter, rifamycin based, TB infection treatment regimens are effective, safe and easier for children to complete. Fluroquinolone-based regimens are recommended for the treatment of children infected by a source case with drug-resistant TB. Directly observed therapy (DOT) programs improve childhood TB infection treatment completion rates. Expert commentary: As shorter, rifamycin-based, TB infection treatment regimens offer superior treatment success rate in both adults and children; the widespread use of these regimens has huge potential to decrease the burden of TB disease worldwide. The implementation of these programs will involve improving patient access to the medications, decreasing their cost to the patient, and the use of novel electronic methods to document patient treatment completion.

Detection of Mycobacterium tuberculosis Complex Using the Xpert MTB/RIF Ultra Assay on the Stool of Pediatric Patients in Dushanbe, Tajikistan

“…TB can progress rapidly in children because of their immature immune system, making diagnosis and treatment more urgent. Prompt detection of TB in children is especially important to enable more timely treatment and improved outcomes ( 5 , 6 ).…”

“…Because TB in young children is often pauci-bacillary, diagnostic methods with high sensitivity are necessary to maximize the likelihood of detection of Mycobacterium tuberculosis (MTB) bacilli. A microbiological diagnosis reduces the risk of misdiagnosis, especially for drug-resistant TB, and the risk of delayed initiation of effective treatment ( 6 ).…”

Detection of Mycobacterium tuberculosis Complex Bacilli and Nucleic Acids From Tongue Swabs in Young, Hospitalized Children

“…In addition to people living with HIV, TB infection in other vulnerable populations such as children continues to contribute significantly to the global burden of morbidity and mortality associated with this disease. Pediatric TB has long been neglected from the perspective of appropriate diagnostic tools and child-friendly chemotherapies ( Lamb and Starke, 2017 ; Thomas, 2017 ; Carvalho et al., 2018 ; Hatzenbuehler and Starke, 2018 ; Furin, 2019 ; Howard-Jones and Marais, 2020 ). As a result, it is estimated that one million children are infected annually with TB, of which almost half are less than 5 years of age and most are not correctly diagnosed or treated ( Jenkins et al., 2014 ; WHO, 2018 ; Reuter et al., 2019 ).…”