Tuberculosis is a pathology of an infectious nature that affects the lungs, both in children and adults. Although many infants are asymptomatic, treatment is still mandatory.
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Tuberculosis (TB) in children is a contagious bacterial infection that affects the lungs, but can also spread to other organs . According to the Centers for Disease Control and Prevention (CDC), the pediatric age is more likely to develop life-threatening forms of this disease.
The worrying data does not end here, as scientific studies estimate that it could be the most prevalent infectious disease in the world. Considering its latent form, it is estimated that 33% of the entire global population has the bacteria. Therefore, knowing the symptoms and prevention of tuberculosis in children is essential.
On the distribution of TB
According to the aforementioned study, more than 10% of the cases of tuberculosis detected annually occur in children. The World Health Organization (WHO) throws a series of illuminating data regarding the situation of the pathology. Some of them are the following:
- Tuberculosis is one of the 10 leading causesof death in the world.
- It is estimated that in 2018, 1.1 million children fell ill with TB.
- Of all these cases, about 250,000 infants died, mostly in cases of coinfection with HIV.
- The TB death rate is higher in infants 0-4 years of age than in any other population group.
This is not all, as other epidemiological studies highlight that young children are more likely to have the bacteria spread beyond the lungs , which generates a much more delicate prognosis. For all these reasons, knowing the symptoms of the disease in infants is vital.
TB is an infectious lung disease, but it can also be complicated by spreading to other organs.
To learn more: Treatment of tuberculosis
What is tuberculosis?
Tuberculosis is an infectious disease of the respiratory system caused by the microorganism Mycobacterium tuberculosis . The main route of transmission is the inhalation of microparticles of saliva from infected people, either by coughing, sneezing, singing or simply by talking.
As with all infectious diseases, there are specific groups that are at higher risk of contracting it. In children, according to the professional portal Healthychildren , they are the following:
- Children who present an adult with tuberculosis or high risk of contracting it in the family nucleus.
- Infants with the HIV virus:in general, they are infected in utero by the mother, who is also positive.
- Children born in a country with a high prevalence of tuberculosis or visiting a geographic area where the disease is widespread.
- Infants living in areas with inadequate health care.
- Young people with conditions that depress the immune system:for example, diabetes or the use of aggressive drugs such as chemotherapy.
Symptoms of tuberculosis in children
At this point, it is necessary to note that most children infected with tuberculosis do not become ill, that is, they are asymptomatic carriers. According to the CDC, this is because, in general, the form of the disease present in infants is less aggressive than that of adults. In addition, its bacterial loads on the mucosa are lower and its cough is less effective.
The question changes when the child has a depressed immune system and, therefore, 24% of infants who die from tuberculosis have an associated HIV infection, according to WHO reports . Still, those with symptoms may show some signs such as the following:
- Fever.
- Slow growth rate.
- Persistent cough
- Night sweats.
- Swollen glands.
How is it diagnosed?
The smear microscopy is the method to follow, as it is based on the differential staining of the patient’s sputum sample (where the pathogenic bacteria are differentiated by a reddish color from the rest). In any case, microscopy only detects half of the cases and does not provide information on the possible resistance to drugs of the bacteria.
For this reason, the World Health Organization recommends the use of the Xpert MTB / RIF ® test, a test that detects the presence of the pathogen and its degree of resistance to rifampin, the most widely used antibiotic to combat the disease. Unfortunately, this body emphasizes that in children, detecting the disease is especially difficult.
Treatment of tuberculosis in children
It is necessary to note that, depending on the progression of the disease in infants, we can detect two types of tuberculosis in children. Based on reports from the University of Rochester , the two main variants are as follows:
- Latent TB infection: occurs when the child has bacteria in his body, but does not show any symptoms. This is because the immune system effectively isolates the pathogen and prevents its multiplication. In most cases, you will have this inactive variant for the rest of your life, even if you do not pass it on.
- TB disease: there are symptoms of an active infection in the infant. In this case, it is positive for the bacteria in the blood or skin test, but the settlement of bacterial colonies in the lungs is also observed. Bacteria are multiplying in the host’s body, so the host can transmit them to healthy people.
Treatment of latent infection
In general, chest radiography is the differential diagnosis between a latent and an active variant. If the child tests positive on a blood or skin test, but her lungs are free of the bacteria, parents can rest assured: she is a carrier, but not in immediate danger.
Still, there is always a risk that the bacteria will start to multiply. Thus, according to sources already cited, the doctor will prescribe the infant the drug isoniazid (INH) for 6 to 12 months, a very effective first-line drug that prevents the disease from progressing.
BCG vaccination is one of the tools for the prevention of tuberculosis in children.
Treatment of TB disease
In the case of an active infection, treatment is not limited to a single drug. Four different antimicrobials must be administered to the infant for a minimum of six months, following a strict dosing protocol.
The complication appears when the bacterial strain causing the disease is multi-resistant to various antibiotics. In some cases, it may require up to the application of long-term chemotherapy or the administration of more aggressive drugs for 24 months.
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Children with tuberculosis as a risk group
Although many children infected with tuberculosis are asymptomatic throughout their lives, the risk of spreading the bacteria to other organs is higher between 0-4 years of age than in any other population group.
For this reason, it is essential to carry out the pertinent diagnostic tests in the infant when an infection by this bacterium is suspected. Factors such as an infected family member, growing up in a country where the prevalence of the disease is high, or not having a home predispose the child to contagion.
