Tuberculosis in the pediatric population: Manifestations and Management

Abstract

Tuberculosis (TB) in children is a significant global health concern, particularly in regions with high TB prevalence. Due to their developing immune systems, children are more susceptible to TB and its severe forms, which can lead to high morbidity and mortality. This paper reviews the epidemiology, clinical manifestations, diagnostic challenges, and management strategies for pediatric TB. The global burden of TB among children is substantial, with millions affected annually. Factors such as malnutrition, HIV infection, and living in crowded conditions exacerbate the risk. High-bur regions include parts of Asia, Africa, and Latin America, where healthcare resources are often limited (World Health Organization, 2022). Clinically, TB in children can present with a wide range of symptoms, including persistent cough, fever, weight loss, and fatigue. Unlike adults, children are more likely to develop extrapulmonary TB, affecting organs such as the lymph nodes, bones, and central nervous system (Starke, 2021). Severe forms like miliary TB and TB meningitis are more common in young children and require prompt diagnosis and treatment. Diagnosing TB in children poses unique challenges due to the non-specific nature of symptoms and the limitations of diagnostic tests. The tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are standard but have limitations. Advances in diagnostic technologies, such as molecular tests like Xpert MTB/RIF, offer improved accuracy (Moore et al., 2024). Treatment involves a combination of first-line and second-line drugs, depending on drug susceptibility. The World Health Organization (WHO) recommends shorter regimens for non-severe drug-susceptible TB. Newer drugs like bedaquiline and delamanid are being used for multidrug-resistant TB in children (Nolt & Starke, 2021). Management challenges include ensuring adherence to treatment, particularly in resource-limited settings. Prevention strategies involve vaccination, prophylactic treatment, and infection control measures. The Bacillus Calmette-Guérin (BCG) vaccine remains crucial in high TB prevalence areas. This review highlights the importance of early detection, appropriate treatment, and comprehensive prevention strategies to improve outcomes for children affected by TB. Ongoing research and innovation are essential for developing new diagnostic tools, treatment options, and preventive measures to combat pediatric TB effectively.

Keywords: Tuberculosis, Pediatric; Pediatric; Population; Tuberculosis Diagnosis; Management;