Updated diagnosis and treatment of childhood tuberculosis
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Updated diagnosis and treatment of childhood tuberculosis Shou-Chien Chen, Kwo-Liang Chen, Kou-Huang Chen, Shun-Tien Chien, Kow-Tong Chen Taiwan, China
Data sources: The literature from a range of sources was reviewed and synthesized to provide an overview of the contemporary approaches for the diagnosis and treatment of childhood TB. Results: This review summarizes the clinical, radiological, bacteriological, and immunological approaches to diagnose TB infection and disease in children. In addition, we summarize the updated guidelines for the treatment of TB in children. Conclusions: The development of better diagnostic and therapeutic methods for childhood TB remains a significant challenge. As the strategies for diagnosis and treatment of childhood TB continue to improve and the knowledge base increases, the implementation of these strategies will be crucial. World J Pediatr 2013;9(1):9-16 Key words: childhood; diagnosis; treatment; tuberculosis
Author Affiliations: Department of Family Medicine, Da-Chien General Hospital, Taiwan, China (Chen SC); General Education Center, Ta Tung University, Taiwan, China (Chen SC); Department of Industrial Engineering and Management, China University of Science and Technology, Taiwan, China (Chen KL, Chen KH); Chest Hospital, Department of Health, Executive Yuan, Taiwan, China (Chien ST); Department of Public Health, College of Medicine, National Cheng Kung University, China (Chen KT) Corresponding Author: Kow-Tong Chen, Department of Public Health, College of Medicine, National Cheng-Kung University, No. 1, University Road, Taiwan, China (Tel: 886-6-2353535 ext 5563; Fax: 886-6-2359033; Email: [email protected]) doi: 10.1007/s12519-013-0404-6 ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2013. All rights reserved.
Introduction
C
hildhood tuberculosis (TB) accounts for approximately 15%-40% of all TB cases. [1-5] High rates of transmission are sustained in TBendemic areas due to high case density and prolonged diagnostic delay. [6] Because childhood TB reflects ongoing transmission, children are most often affected in areas where the adult epidemic is poorly controlled.[7] In addition, childhood TB remains neglected for various reasons, including the difficulty in diagnosing pulmonary TB, the lack of scientific studies on childhood TB, the largely unknown outcomes of children with TB, and the belief that childhood TB is not an important factor in TB control.[8,9] In recent years, there have been several important developments in the diagnosis and treatment of childhood TB infection and disease. This article provides a brief overview of current controversies and recent advances in the care of children with TB with an emphasis on intrathoracic disease.
Data collection
We initially collected all of the articles that were published from January 2002 to June 2012, which described children who were affected by TB. These articles were obtained by searching MEDLINE using the key words "childhood tuberculosis" and
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