Tuberculosis (TB) remains one of the world’s deadliest infectious diseases, and children are among its most vulnerable victims. Caused by the bacterium Mycobacterium tuberculosis, TB predominantly affects the lungs but can also impact other parts of the body, such as the brain, spine, and kidneys. While adults are more commonly diagnosed, TB in children presents unique challenges due to their developing immune systems and often nonspecific symptoms, making early diagnosis and treatment essential.
Children are often infected by close contact with an adult who has active TB, usually a family member. Unlike adults, children are more likely to develop severe forms of TB, including miliary TB and TB meningitis, especially if they are under five years old or malnourished. Infants born to mothers with active TB or children living in overcrowded and unsanitary conditions are at heightened risk. Immunocompromised children, especially those with HIV, are also more susceptible.
The symptoms of TB in children can be subtle and vary depending on the organ affected. In many cases, they may resemble symptoms of common illnesses, which contributes to underdiagnosis. Some typical signs to watch for include:
Persistent cough lasting more than 2–3 weeks
Unexplained fever, often low-grade and in the evenings
Weight loss or failure to thrive, especially in younger children
Fatigue or decreased playfulness
Night sweats
Loss of appetite
Swollen lymph nodes, particularly in the neck
In cases where TB spreads beyond the lungs, additional symptoms may appear. For example, TB meningitis may cause headaches, vomiting, drowsiness, or seizures. Miliary TB, a severe form of the disease, can cause difficulty breathing and generalized weakness.
Prevention of TB in children largely revolves around public health measures and individual precautions:
Early Detection and Treatment: Prompt diagnosis and treatment of TB in adults is crucial to prevent spread to children. If someone in the household has TB, children should be screened immediately.
BCG Vaccination: The Bacille Calmette-Guérin (BCG) vaccine is administered to newborns in many countries where TB is endemic. While it does not completely prevent TB, it significantly reduces the risk of severe TB forms, such as meningitis in children.
Improved Living Conditions: Reducing overcrowding, ensuring proper ventilation, and maintaining good hygiene help limit the transmission of TB.
Nutrition and Immunity: Ensuring children have a healthy, balanced diet boosts their immune systems, making them less susceptible to infections in general, including TB.
Avoiding Exposure: Children, especially infants, should not be in close contact with individuals known to have active TB, particularly if those individuals are not yet on effective treatment.
Parents and caregivers should be alert to any persistent or unusual symptoms in children. It is especially important to consult a doctor if:
The child has been in close contact with someone diagnosed with TB.
There is a persistent cough, fever, or weight loss without any clear cause.
The child appears unusually tired or shows signs of developmental delays or regression.
There is swelling in the neck or other parts of the body without injury.
The child has a known weakened immune system or other underlying health conditions.
A pediatrician may order a TB skin test (Mantoux test), blood tests, chest X-rays, or more advanced diagnostics like GeneXpert or sputum tests if the child is old enough.
Tuberculosis in children is a serious yet often overlooked health issue. Because children may not always exhibit classic TB symptoms, awareness among parents and caregivers is critical. With timely diagnosis, effective treatment, and preventive measures, TB in children is both treatable and preventable. Promoting vaccination, ensuring healthy environments, and seeking prompt medical attention can save lives and protect children from this age-old threat.
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