chapter  21
44 Pages

Tuberculosis in Children

Tuberculosis continues to be a significant cause of morbidity and mortality for children throughout the world. After a steady decline in the number of cases for decades, there was a resurgence of pediatric tuberculosis in the United States and other industrialized countries from 1984 to 1994 (1,2). Tuberculosis infection and disease among children are much more prevalent in developing countries, where resources for tuberculosis control are scarce (3,4). Since most children with tuberculosis infection and disease acquire the organism from adults in their environment, the epidemiology of childhood tuberculosis follows that in adults. The most important reasons for this recent worldwide resurgence of pediatric tuberculosis include (1) increased population migration, (2) the human immunodeficiency virus (HIV) epidemic, (3) the emergence of drug resistance (5,6), (4) continued poverty and poor access to medical care, and (5) inadequate public health infrastructure required to prevent tuberculosis in children. The World Health Organization (WHO) has estimated that in the 1990s, about 15 million new cases and 5 million deaths due to tuberculosis will occur among children under 15 years of age (7).