J Pediatr Infect Dis 2018; 13(02): 091-100
DOI: 10.1055/s-0037-1606601
Review Article
Georg Thieme Verlag KG Stuttgart · New York

The Epidemiology of Tuberculosis in Children

Ameneh Khatami
Department of Pediatric Infectious Diseases, University of New York Langone Medical Center, New York, United States
Division of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
,
Ben Marais
Division of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
Department of Infectious Diseases and Microbiology, Children's Hospital at Westmead, Sydney, New South Wales, Australia
Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, University of Sydney, Sydney, New South Wales, Australia
› Author Affiliations
Further Information

Publication History

23 March 2017

27 March 2017

Publication Date:
05 October 2017 (eFirst)

Abstract

The epidemiology of tuberculosis, particularly in children, is highly intertwined with socio-political factors, such as poverty, access to healthcare, and migration. Growing evidence around the world shows that more children have tuberculosis (TB) than was previously thought, most of whom are undiagnosed and untreated, and that TB is a significant cause of morbidity and mortality in children in TB endemic areas. Since TB in young children results from recent transmission, the incidence of pediatric TB is a marker of epidemic control in a community and an indirect indicator of the effectiveness of TB control programs. It is estimated that pediatric TB represents between 4 and 21% of all TB cases, depending on the background prevalence in the country, and at least 10 to 20% of the total cases in areas with poor epidemic control. However, a precise estimate of the global burden of TB in children is difficult due to challenges in case ascertainment, diagnosis, and weak surveillance systems in many countries with a high burden of disease. Several recent estimates highlight these difficulties and provide a starting point to motivate further study. In addition, since drug-resistant TB in young children reflects transmission of resistant strains in the community and occurs with the same frequency as in treatment-naive adults, accurate monitoring of drug-susceptibility patterns in pediatric TB cases will inform optimal empiric treatment regimens in both adults and children, in the context of increasing rates of drug-resistant TB globally.