What is tuberculosis (TB)?
It is an airborne infection that primarily affects the lungs and is caused by a bacterium called Mycobacterium tuberculosis.
Who is at risk?
Infants and young children are at a higher risk of developing life-threatening forms of TB compared to older children and adults. In fact, TB is more prevalent in children under the age of 5 and those older than 10 years. Children with lower immunity and those living with a family member who has TB are at an increased risk of contracting the disease. Also, children born in a country where TB is widespread or in communities that receive inadequate medical care are at a higher risk.
How do children develop TB?
Coughing by an older TB patient leads to bacteria being expelled into the air, and when a child inhales the germs, he can become infected with TB. Children under the age of 10 years rarely infect others, as they expel fewer bacteria due to their weaker cough strength. However, not every child inhaling the bacteria develops TB. Therefore, two TB-related conditions exist:
Latent TB infection: Children with latent infection have TB bacteria in their bodies, but they are not active. Such children would not show the symptoms of the disease and will not spread the infection to others. However, they are often given medications to prevent them from developing the disease.
TB disease: When TB bacteria in children's bodies become active and start multiplying, they fall sick. Such children show symptoms of the disease and need medications to treat the condition.
Symptoms of TB:
Signs and symptoms of TB in children include:
- Persistent cough
- Heavy and fast breathing
- Night sweats
- Weakness, lethargy or reduced playfulness
- Weight loss and poor growth
In some children, TB can spread through the bloodstream and affect other organs of the body also. This necessitates more complicated treatment, which should be started at the earliest.
How is TB diagnosed?
All children who are at risk of or suspected to have TB should receive a tuberculin skin test. The test can be performed in the paediatrician’s office.
How is TB treated?
If the skin test returns positive for TB, a chest x-ray is performed to look for evidence of active or past infection in the lungs. If the x-ray shows evidence of infection, the paediatrician will also order a test of the child’s cough secretions to screen for bacteria.
If only the skin test is positive and there is no evidence of active TB infection, the paediatrician will treat the child to prevent the infection from becoming active. But if all the tests show that the child has active infection, the paediatrician will prescribe medications that should be continued for 6–12 months. It is important to continue taking the medications for the duration prescribed by the paediatrician. Stopping the medicines before the treatment is over can make the child fall sick again.
How to prevent TB?
In many countries, the BCG, or Bacillus Calmette-Guerin, vaccine is administered to prevent childhood TB. The disease can also be prevented from spreading by isolating the TB patient, especially from young children, until treatment is initiated. All family members in regular contact with the patient should also seek medical opinion.