By ULY CLINIC staff

 

Tuberculosis in children

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Introduction

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Tuberculosis (TB) is a chronic infectious disease caused mainly by Mycobacterium tuberculosis.

 

The most common symptoms of active TB include infection include fever, cough, weight loss, and chills however children are less likely to show symptoms

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Tuberculosis is classified into 2 clinical types:

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Pulmonary Tuberculosis (PTB)

 

This is a most common type of TB that affect the lungs parenchyma

 

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Extrapulmonary Tuberculosis(EPTB):

 

This type of TB have various subtype the common one in children includes

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• TB lymphadenopathy

• Disseminated/MilliaryTB

• TB effusions (pleural, pericardial and peritoneal)

• Spinal TB

• TB meningitis

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Diagnostic Criteria

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• Cough for more than 2 weeks

• Unexplained fever for more than 2 weeks

• Contact with an adult or older children with smear positive PTB.

• Excessive night sweats

• Failure to gain weight or weight loss (use growth charts).

Infections not responding to conventional antibiotics.

Note:

• Use TB scoring chart for Diagnostic (Annex 1)
   

Investigations

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• Sputum or gastric aspirate for ZN Stain

• Chest X-Ray

• Mantoux test

• Gene X-pert

• FBP

• Erythrocyte Segmentation Rate(ESR)

• Sputum for AFB culture and sensitivity when indicated e.g. treatment failure/relapse.

 

Treatment

Pharmacological treatment

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• Currently the recommended regimen is Short Course Chemotherapy 
  (SCC) by Directly Observed Treatment (DOT) throughout the duration of treatment as shown in the table below.

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Non Pharmacological treatment

• Encourage breastfeeding, balance diet and adequate fluid intake

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Table below shows TB chemotherapy in children