The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children

TB is a major public health problem causing 9 million cases, of which 10%-15% occur in children each year. Historically, children have received lower priority within TB control activities because they are considered less infectious than smear-positive adults. This review argues that TB is a public h...

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Main Author:	Cuevas, L. E.
Format:	Journal Article
Language:	EN
Published:	2012
Subjects:	Child Humans Molecular Diagnostic Techniques Nucleic Acid Amplification Techniques Public Health Tuberculosis
Online Access:	http://hdl.handle.net/10986/5070

id	okr-10986-5070
recordtype	oai_dc
spelling	okr-10986-50702021-04-23T14:02:20Z The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children Cuevas, L. E. Child Humans Molecular Diagnostic Techniques Nucleic Acid Amplification Techniques Public Health Tuberculosis TB is a major public health problem causing 9 million cases, of which 10%-15% occur in children each year. Historically, children have received lower priority within TB control activities because they are considered less infectious than smear-positive adults. This review argues that TB is a public health problem in children and that poor awareness of the magnitude of the problem emanates from the lack of suitable pediatric diagnostic tests for TB and the characteristics of the disease in young children. New TB diagnostics, approved for use in adults have not been evaluated in children, although there is limited evidence that some of these tests hold promise and should be assessed. There are several approaches that could be used to improve the performance of tests in pediatric patients. These include improved methods for specimen collection and processing. The value of collecting specimens from multiple anatomical sites to shorten the diagnostic process and improve sensitivity was reported recently and the combination of expectorated sputum, nasopharyngeal aspirate, induce sputum and gastric aspirate may result in a similar yield than specimens collected over consecutive days. Methods for sample collection such as fine needle aspiration biopsy should be used more frequently and the Microscopic Observation Drug Sensitivity (MODS) assay has higher sensitivity than LJ culture. There is however very scanty evidence of the performance of other promising tests such as the fully automated NAAT (Xpert) and Line Probe Assays and loop mediated isothermal amplification. Although the future holds promise, increased support from international organizations and funding agencies is needed to promote the evaluation and development of new diagnostics that are suitable for TB in children. 2012-03-30T07:31:08Z 2012-03-30T07:31:08Z 2011 Journal Article Indian J Pediatr 0973-7693 (Electronic) 0019-5456 (Linking) http://hdl.handle.net/10986/5070 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	EN
topic	Child Humans Molecular Diagnostic Techniques Nucleic Acid Amplification Techniques Public Health Tuberculosis
spellingShingle	Child Humans Molecular Diagnostic Techniques Nucleic Acid Amplification Techniques Public Health Tuberculosis Cuevas, L. E. The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children
relation	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
description	TB is a major public health problem causing 9 million cases, of which 10%-15% occur in children each year. Historically, children have received lower priority within TB control activities because they are considered less infectious than smear-positive adults. This review argues that TB is a public health problem in children and that poor awareness of the magnitude of the problem emanates from the lack of suitable pediatric diagnostic tests for TB and the characteristics of the disease in young children. New TB diagnostics, approved for use in adults have not been evaluated in children, although there is limited evidence that some of these tests hold promise and should be assessed. There are several approaches that could be used to improve the performance of tests in pediatric patients. These include improved methods for specimen collection and processing. The value of collecting specimens from multiple anatomical sites to shorten the diagnostic process and improve sensitivity was reported recently and the combination of expectorated sputum, nasopharyngeal aspirate, induce sputum and gastric aspirate may result in a similar yield than specimens collected over consecutive days. Methods for sample collection such as fine needle aspiration biopsy should be used more frequently and the Microscopic Observation Drug Sensitivity (MODS) assay has higher sensitivity than LJ culture. There is however very scanty evidence of the performance of other promising tests such as the fully automated NAAT (Xpert) and Line Probe Assays and loop mediated isothermal amplification. Although the future holds promise, increased support from international organizations and funding agencies is needed to promote the evaluation and development of new diagnostics that are suitable for TB in children.
format	Journal Article
author	Cuevas, L. E.
author_facet	Cuevas, L. E.
author_sort	Cuevas, L. E.
title	The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children
title_short	The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children
title_full	The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children
title_fullStr	The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children
title_full_unstemmed	The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children
title_sort	urgent need for new diagnostics for symptomatic tuberculosis in children
publishDate	2012
url	http://hdl.handle.net/10986/5070
_version_	1764393825468416000

The Urgent Need for New Diagnostics for Symptomatic Tuberculosis in Children

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