Drug Resistant Tuberculosis in Children: Why Are Children so Special?

Multidrug-Resistant Tuberculosis Workshop
DRUG RESISTANT TUBERCULOSIS IN CHILDREN: WHY ARE CHILDREN ARE SO SPECIAL?

Asiah Kassim
Tunku Azizah Hospital, Kuala Lumpur, Malaysia

Why are children special? Children are not small adults. World Health Organization (WHO) started to collect data from children 14 years old and below in 2012. The understanding of TB in children is lagging compared to adults with TB. The broad clinical presentation of TB in children is not helping in making early TB diagnosis. The diagnostic tool for children is not well established including for DRTB as the majority of children with TB are in paucibacillary status. Therefore, most diagnoses are smear-negative TB and their bacteriological status depends on their history of contact with DRTB subjects, suspicion of DRTB or not responsive to first-line TB therapy. Due to a lack of therapeutic trials on children especially the young age group, many new TB drugs do not have clear safety data for children. As a result, managing DRTB in children is challenging, especially from suspicion to making the right diagnosis and delivering appropriate management