La tuberculosis remains a global epidemicBefore COVID-19 arrived, it was the infectious disease that caused the most deaths. Lest we forget, a day like today is remembered: World Tuberculosis Day. Although the WHO has not released data this year, estimates are that childhood tuberculosis accounts for about 6% of all new cases. These are mainly concentrated in countries with a high burden of disease.
Diagnosing tuberculosis in children is not such an easy task, since in many cases it is masked with other types of diseases. About this difficulty, and how COVID-19 has affected this disease, we will talk to you in the following article. If you want to have more details about childhood tuberculosis we recommend you click here.
Difficulties in diagnosing tuberculosis in children
In childhood the diagnosis of tuberculosis is a challenge, since the methods available, such as smear microscopy and cultures are usually false negatives. Other tuberculin skin tests (PPD) and IGRAS are complementary with variable sensitivity and specificity. What this test reveals is a past bacterial infection, even if the child has had no symptoms.
Taking X-rays is essential in suspicious patients. Some of the factors that make it difficult to estimate the burden of tuberculosis in the child population are:
- Difficulty in establishing a definitive diagnosis.
- Presence of extrapulmonary disease
- Low priority for public health
Currently, all strategies to try to end the TB epidemic have focused on improve early diagnosis worldwide. The WHO and multiple organizations dedicate efforts to improve the prevention, diagnosis, and timely treatment of childhood tuberculosis, but the goals set for 2030 have not yet been achieved.
Children with tuberculosis, but not sick
Children can suffer from tuberculosis at any age, but the most common range is between 1 and 4 years. About 90% of infected children do not get sick. These children who do not get sick, for many of them, tuberculosis remains a latent infection. Later on, a future transmission of the disease may occur when post-primary Tuberculosis (TBC) reactivates.
The rest of the children, those who do get sick, that approximately 10% do so during the first 5 years after infection. When a child falls ill, it is almost always synonymous with recent infection, therefore, it is very important to find the first case that infected it. This contagion usually occurs, almost always, a close contact within the home or in their school environment.
It is not usual for children under 10 years of age with tuberculosis of the lungs to infect other people. These usually have very little bacteria in their mucus and have a relatively ineffective cough. The most important thing to remember is that tuberculosis is predictable and curable.
How COVID-19 Affects Childhood Tuberculosis
In a press release sent by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) it has been alerted that tuberculosis and COVID-19 are similar respiratory epidemics and they can be confused. Both have a cough, fever, and shortness of breath. One infection aggravates the other and in the case of co-infection there is a higher mortality.
On the other hand, the emergence of the coronavirus has caused the routine of Health care services for tuberculosis, in many countries, have been suspended. As has happened with other pathologies, the current coexistence of COVID-19 with tuberculosis has reduced the quality of care, continuity of care and less investment in research.
At this time, as mentioned before, efforts are being made to find more methods for rapid diagnosis and new drugs that shorten the duration of treatments to less than six months. Whether cases are reported depends on the intensity of the epidemic, the ages of the affected population, the diagnostic tools available, and the extent to which they are practiced in locating contacts.