Tuberculosis
- Topics
- Basic TB Facts
- Treatment
- Testing & Diagnosis
- TB & HIV Coinfection
- Infection Control & Prevention
- Drug-Resistant TB
- TB in Specific Populations
- African-American Community
- Correctional Facilities
- Table of Contents
- Introduction
- Strengthen TB Information Systems and Program Assessment
- Strengthen TB Environmental Controls and Isolation Practices
- Provide More Comprehensive and Timely Screening and Diagnostic Evaluations
- Develop and Strengthen Contact Investigation Protocols
- Increase HIV Counseling and Testing
- Increase Staff Training
- Strengthen Collaboration Between Health Departments and Jails
- International Travelers
- Pregnancy
- Disaster Responders
- Children
- Vaccines & Immunizations
- Laboratory Information
- Drug Susceptibility Testing
- The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TB
- Rapid Molecular Testing to Detect Drug-Resistant TB in the US
- Executive Summary
- Introduction
- Background on Tests for Molecular Detection of DR
- General Considerations and Principles for a Molecular DR Testing Service�
- Possible Scenarios and Scope of Testing for a Molecular DR Testing Service
- Research Needs
- General Recommendations of the Expert Panel
- Communication Plan for the Report
- Recommendations
- References
- Panel Members and CDC Participants
- Appendix 1
- Appendix 2
- Appendix 3
- Interim Laboratory Biosafety Guidance for XDR Mycobacterium tuberculosis strains
- Molecular Detection of Drug Resistance (MDDR)
- Research
- TB Epidemiologic Studies Consortium
- Background
- Infrastructure
- Research Projects
- Publications
- Meetings
- Directory
- TBESC Committee Members
- Translating Research into Practice (TRIP)
- Contact TBESC
- Prospective Evaluation of Immunogenetic and Immunologic Markers for Susceptibility to Tuberculosis Infection and Progression from M. Tuberculosisinfection to active TB
- Zero Tolerance for Pediatric TB
- Models for Incorporating HIV Counseling, Testing, and Referral into Tuberculosis Contact Investigations
- Prevalence of Latent TB Infection Among High Risk Populations in the United States
- Regional Capacity-Building in Low-Incidence Areas
- Use of Network Analysis Methods to Characterize M. tuberculosis Transmission Patterns Among Women and Other High-Risk Populations
- An Analysis of Molecular Epidemiology of Multi-Drug Resistant M. tuberculosisin the United States
- Missed Opportunities for TB Prevention in Foreign-Born Population in the United States and Canada
- New Model for Assessing TB Surveillance and Action Performance and Cost
- Addressing TB Among African Americans in the Southeast: Identifying and Overcoming Barriers to Treatment Adherence for Latent TB Infection and TB Disease
- Assessing the TB Knowledge, Attitudes, Beliefs, and Practices Among Private Providers Serving Foreign-born Populations at Risk for TB
- Factors Associated with Acceptance of, Adherence to and Toxicity From Treatment for Latent TB Infection and Pilot Study of Treatment for Latent TB Infection Effectiveness
- Culturally Appropriate TB Educational Materials for Leaders and Staff of Hispanic Service Organizations
- Enhancing TB Programs� Capacity for Self-Evaluation: Testing New Tools and Developing an Evaluation Toolkit
- African Refugee Women�s Health Improvement Project
- Evaluation of the TK Medium: A New Rapid Solid Culture System for Tuberculosis
- Evaluation of New Interferon-y Release Assays in the Diagnosis of Latent TB Infection in Health Care Workers
- Request for Proposal
- TB Trials Consortium
- Behavioral & Social Science Research
- TB Epidemiologic Studies Consortium
- Data & Statistics
- Education & Training
- Resources for TB Programs
- Publications & Products
- Fact Sheets
- General
- Fact sheets - Spanish
- TB - General Information
- The Difference Between Latent TB Infection and Active TB Disease
- Diferencia entre la infección de tuberculosis latente y enfermedad de tuberculosis activa
- A Global Perspective on TB
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Bovine Tuberculosis in Humans
- Tuberculosis Information for International Travelers
- TB Can Be Treated
- Exposure to TB
- TB and HIV/AIDS
- You Can Prevent TB
- Testing for TB
- Tuberculosis: informaci�n general
- Diferencia entre la infecci�n de tuberculosis latente y enfermedad de tuberculosis activa
- Informaci�n sobre la tuberculosis para los viajeros internacionales
- Exposición a la tuberculosis
- Usted puede prevenir la tuberculosis
- La tuberculosis puede ser tratada
- Tuberculosis y VIH/SIDA
- Usted puede prevenir la tuberculosis
- Pruebas para detectar la tuberculosis
- Data & Statistics
- A Global Perspective on TB
- Trends in Tuberculosis – United States
- The Revised Report of Verified Case of Tuberculosis
- The National Tuberculosis Indicators Project (NTIP)
- National Tuberculosis Indicators Project (NTIP): Frequently Asked Questions
- TB Genotyping
- TB Genotyping Information Management System (TB GIMS)
- Drug-Resistant TB
- Multidrug-Resistant Tuberculosis (MDR TB)
- Extensively Drug-Resistant Tuberculosis (XDR TB)
- CDC’s Role in Preventing Extensively Drug-Resistant Tuberculosis (XDR TB)
- Tuberculosis multirresistente (MDR)
- Tuberculosis extremadamente resistente (XDR)
- El papel de los CDC en la prevenci�n de la tuberculosis extremadamente resistente (XDR)
- Infection Control & Prevention
- TB in Specific Populations
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Tuberculosis in Minorities
- Tuberculosis Information for International Travelers
- TB and HIV/AIDS
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tuberculosis in Blacks
- Tuberculosis and Pregnancy
- Tuberculosis y embarazo
- Treatment
- TB Can Be Treated
- Treatment of Latent TB Infection
- Treatment of Latent Tuberculosis Infection: Maximizing Adherence
- Treatment Options for Latent Tuberculosis Infection
- Treatment of Drug-Resistant Tuberculosis
- Treatment of Drug-Susceptible Tuberculosis Disease in Persons Not Infected with HIV
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tratamiento de la infecci�n de tuberculosis latente
- Testing & Diagnosis
- TB Can Be Treated
- Testing for TB
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- Interferon-Gamma Release Assays (IGRAs)
- Tuberculin Skin Testing
- Diagnosis of Tuberculosis Disease
- Targeted Tuberculin Testing and Interpreting Tuberculin Skin Test Results
- Prueba cutánea de la tuberculina
- Diagnóstico de la tuberculosis activa
- Vaccines & Immunizations
- General
- Guidelines
- Guides & Toolkits
- Core Curriculum
- Self-Study Modules
- Report of Verified Case of Tuberculosis (RVCT)
- Forging Partnerships to Eliminate TB
- Understanding the TB Cohort Review Process
- Latent Tuberculosis Infection: A Guide for Primary Health Care Providers
- Effective TB Interviewing for Contact Investigation
- Mantoux Tuberculin Skin Testing Products
- Ethnographic Guides
- Newsletters
- Pamphlets, Brochures, Booklets
- Posters
- Mantoux Tuberculin Skin Test Wall Chart
- World TB Day
- Afiches
- 2011 Poster (English)
- 2011 Poster (Spanish)
- 2010 Poster (English)
- 2010 Poster (Spanish)
- 2008 Poster (English)
- 2008 Poster (Spanish)
- 2006 Poster (English)
- 2004 Poster (English)
- 2004 Poster (Spanish)
- 2003 Poster (English)
- 2003 Poster (Spanish)
- 2003 Now is the Time Poster (English)
- 2003 Now is the Time Poster (Spanish)
- Think TB
- Stop TB
- Reports & Articles
- Morbidity and Mortality Weekly Reports (MMWRs)
- Contact Investigations
- Control and Elimination
- Data & Statistics
- Drug-Resistant Tuberculosis
- Infection Control & Prevention
- Laboratory
- TB in Specific Populations
- Foreign-Born
- High-Risk Settings
- Homeless
- International
- Occupational Groups
- Travel
- TB & HIV
- Testing & Diagnosis
- Treatment
- LTBI Updates
- Vaccines & Immunizations
- World TB Day
- DTBE Authored Journal Articles
- Tuberculosis Laboratory Aggregate Reports
- Morbidity and Mortality Weekly Reports (MMWRs)
- Slide Sets
- Core Curriculum
- Self-Study Modules
- Prevention and Control of Tuberculosis in Correctional and Detention Facilities
- Guidelines for Preventing the Transmission of M. TB in Health care Settings
- Investigation of Contacts of Persons with Infectious TB
- Text-Only version
- Introduction
- Decisions to Initiate a Contact Investigation
- Investigating the Index Patient and Sites of Transmission
- Assigning Priorities to Contacts
- Diagnostic and Public Health Evaluation of Contacts
- Medical Treatment for Contacts with LTBI
- When to Expand a Contact Investigation
- Communicating Through the News Media
- Data Management and Evaluation of Contact Investigations
- Confidentiality and Consent in Contact Investigations
- Staff Training for Contact Investigations
- Contact Investigations in Special Circumstances
- Source-Case Investigations
- Cultural Competency and Social Network Analysis
- Resources
- Epidemiology of Pediatric Tuberculosis in the United States
- Text-Only version
- Introduction
- Pediatric TB Cases by Age and Race
- Pediatric TB Cases by Origin of Birth
- Pediatric Cases, Percentages and Rates by States
- Pediatric TB Cases by Case Verification Criterion and Site of Disease
- Pediatric TB Cases in Specific Groups
- Pediatric TB Cases Case Completion
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- Slide 23
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- Slide 25
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- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Treatment of TB
- Targeted Tuberculosis Testing and Treatment of Latent Tuberculosis Infection
- CD Roms
- Electronic Tools & Resources
- Web-Based Courses & Webinars
- Fact Sheets
- Global TB
- Events
- Links
- About Us
- Mission Statement and Activities
- Organization Chart
- Advisory Groups
- Federal TB Task Force
- Table of Contents
- Executive Summary
- Introduction
- Chronology in the Development of This Report
- Strategies for Maintaining Control of TB
- Strategies for Accelerating the Decline of TB
- Activities for Developing New Tools
- Global U.S. Actions
- Assessing the Impact of Actions Taken
- Federal TB Task Force Members and Others Involved in the Development of This Report
- Glossary
- References
- Federal TB Task Force Roster
- Table of Contents
- Executive Summary
- Introduction
- How to Eliminate TB? – The IOM Report
- Why Eliminate TB? – Rationale for Elimination
- Who Will Lead? – CDC's Response
- Goal I: Maintain control of TB
- Goal II: Accelerate the decline
- Goal III: Create new tools
- Goal IV: Reduce the global burden of TB
- Goal V: Summon and sustain support
- Goal VI: Track progress
- References
- Federal TB Task Force
- Funding
TB in Children (Global Perspective)
In many countries, tuberculosis (TB) disease is much more common than in the United States. The World Health Organization (WHO) estimates at least half a million children (less than 15 years of age) get sick with TB disease each year worldwide. However, it is difficult to estimate the true burden of TB among children globally, due to a lack of routine reporting of childhood TB by National TB Programs (NTPs), and the challenges of confirming the diagnosis of TB disease in children. The incidence of TB in children is influenced by various factors including:
- The incidence of TB disease in the community;
- The effectiveness of finding persons with TB disease and managing treatment;
- Bacille Calmette-Guerin (BCG) vaccine coverage; and
- The prevalence of risk factors for TB disease in children.
WHO estimates that childhood TB accounts for 6% of all incident TB cases worldwide, with most of the cases occurring in countries with a high rate of TB disease. Children can be diagnosed with TB disease at any age, but the most common is between 1 and 4 years of age. TB infection or TB disease in a child represents recent and ongoing TB transmission in their community.
TB Infection and TB Disease
TB is caused by a bacterium called Mycobacterium tuberculosis. TB bacteria are spread from person to person through the air. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks or sings. People nearby may breathe in these bacteria and become infected. Not everyone infected with TB bacteria becomes sick with TB disease. As a result, two TB-related conditions exist: latent TB infection (LTBI) and TB disease. The only sign of latent TB infection is a positive reaction to the tuberculin skin test (TST) or TB blood test. Tuberculin skin testing is considered safe in children, and is preferred over TB blood tests for children less than 5 years of age. In children, the TST is also useful as an aid in the diagnosis of TB disease. However, children with HIV infection who also have TB infection may not always have a positive TST result because they have a weakened immune system; a normal immune response is required to produce a positive TST reaction.
Once infected with TB bacteria, children (especially those children with risk factors for developing TB, for example, younger age, HIV, or other immune compromising conditions), are more likely to get sick with TB disease and to get sick more quickly. Treatment with isoniazid (isoniazid preventive therapy [IPT]) can reduce the chances of TB infection progressing to TB disease. This treatment is recommended by WHO for children less than 5 years of age who come in contact with someone with infectious TB disease, and for children with HIV infection.
Diagnosis of TB Disease in Children
WHO guidelines for diagnosing TB in children are similar to U.S. guidelines. WHO recommends the following approach for diagnosing TB in children outside the United States:
- Obtain medical history (including history of any symptoms consistent with TB disease and history of being in contact with someone diagnosed with infectious TB disease)
- Provide physical examination (including growth assessment)
- Conduct tuberculin skin testing (TST)
- Obtain and send specimens for laboratory testing for TB (bacteriological confirmation)-whenever possible
- Conduct other diagnostic testing (e.g., chest x-ray) relevant for suspected pulmonary (lung) TB and suspected extrapulmonary (other parts of the body) TB
- Provide HIV testing (in high HIV prevalence areas)
Key risk factors for TB in children are:
- Household or other close contact with a person with infectious TB disease
- Age less than 5 years
- HIV infection
- Severe malnutrition
(For more information, refer to Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children)
TB and HIV Co-infection in Children
Worldwide, TB is one of the leading causes of death among people infected with HIV. HIV infection is common in children with TB in regions endemic for TB and HIV. Children with HIV are at a greater risk for TB infection and TB disease than children without HIV infection.
TB Treatment
TB treatment outcomes in children are generally good, provided treatment starts promptly. The response to TB treatment is poorer in children with HIV infection than in children without HIV infection.
In 2010, WHO revised its guidance regarding treatment of TB in children outside the United States. The revised guidance included revised recommendations for pediatric dosages of the four essential anti-TB medicines. (Refer to Rapid Advice: Treatment of Tuberculosis in Children for detailed information.)
TB Vaccine
BCG, or bacille Calmette-Guerin, is a vaccine that is given to prevent TB disease. It is most effective in preventing severe forms of TB disease, such as TB meningitis and disseminated TB, in infants and young children. BCG is not routinely used in the United States. However, many people born outside of the United States have been BCG-vaccinated. More information about BCG vaccine policies and practices globally can be found at the BCG World Atlas website.
In 2007, WHO revised its BCG vaccine recommendations for infants at risk for HIV infection and now recommends that children known to be HIV-infected, even if asymptomatic, should not be immunized with the BCG vaccine. (Refer to Revised BCG vaccination guidelines for infants at risk for HIV infection for more information.)
Related Links
- IUATLD Child Lung Health website
- World Health Organization Website – Childhood Tuberculosis Page
- Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children (WHO, 2006)
- Rapid Advice: Treatment of Tuberculosis in Children (WHO, 2010)
- Guidance for National Tuberculosis and HIV Programmes on the Management of Tuberculosis in HIV-infected Children: Recommendations for a public health approach (WHO/IUATLD 2010)
- BCG fact sheet
- BCG World Atlas
For Clinicians
- Desk guide for diagnosis and management of TB in children (IUATLD, 2010)
- Guidance for National Tuberculosis and HIV Programmes on the Management of Tuberculosis in HIV-infected Children: Recommendations for a public health approach (WHO/IUATLD, 2010)
- Dosing instructions for the use of currently available fixed-dose combination TB medicines for children (WHO, 2009)
- Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children (WHO, 2006)
- Stop TB Partnership-Tuberculosis in Countries
- Revised BCG vaccination guidelines for infants at risk for HIV infection (WHO, 2007)
Contact Us:
- Centers for Disease Control and Prevention
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