TUBERCULOSIS IN CHILDREN- RECENT ADVANCES
India has one of the highest TB burdens globally, accounting for 20% of the new 8.6 million TB cases annually.
While the burden of childhood TB in India is not known, regional data from the World Health Organization (WHO) indicate that sputum microscopy smear-positive TB in children (<14 years old) accounts for 0.6%–3.6% of all reported cases.
However, because the majority of children are sputum microscopy smear negative, these data underestimate the true burden of childhood TB. It is estimated that childhood TB constitutes 10–20% of all TB in high-burden countries accounting for 8–20% of TB-related deaths The epidemiology of TB in young children (<5 years old), a vulnerable population where diagnosis and treatment are most challenging, is not well understood, especially in countries with limited public health resources.
Furthermore, while several studies have described the pediatric TB epidemic in high HIV/TB coinfection settings such as sub-Saharan Africa, few studies have focused on TB during early childhood in India.
Drug-resistant (DR) strains of Mycobacterium tuberculosis are highly prevalent (10–51%) in this region, and young children are notoriously difficult to diagnose and treat
Diagnosis of TB is very challenging in young children, and current tools are inadequate. The rates of extra-pulmonary and meningeal TB are very high in this vulnerable population, making the task of definitive diagnosis even more challenging. Furthermore, while the data on DR-TB are limited by the small sample size in the current study, they are however concerning, and additional studies are needed to more accurately define the prevalence of DR in this population.
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