Diagnostic Measures in Childhood Tuberculosis: A Short Review

Abstract

The trends of incidence, morbidity and mortality of tuberculosis in children have always remained unclear because of lack of a definitive diagnostic tool in mostly cases. The diagnosis of tuberculosis in children remains a major challenge as it is seldom confirmed and is mostly based on clinical signs, symptoms and special investigations e. g. TST, chest X-ray and sputum smear microscopy. Sputum smear microscopy is positive in less than 10-15% of children with TB and culture yields are nearly about 30-40%. In low burden countries, the triad of (a) known contact with an infectious source case, (b) a positive tuberculin skin test and (c) a suggestive CXR is usually used to establish a diagnosis of childhood TB. The research on childhood tuberculosis is often neglected due to technical difficulties like slow growth in culture, the difficulty of obtaining specimens and the diverse and relatively nonspecific clinical presentation of tuberculosis in this age group. The complexity in making an exact diagnosis of tuberculosis in children have led to the development of several diagnostic approaches like point scoring systems, diagnostic classifications and diagnostic algorithms. The aim of this study was to review and analyse the different diagnostic approaches to childhood tuberculosis. In this paper, the mostly used techniques like culture methods as well as the non-culture methods including serology, biochemistry and polymerase chain reaction and DNA fingerprinting for the diagnosis of tuberculosis will be discussed.

Keywords: Diagnostic measures, Childhood, Tuberculosis