Professional Documents
Culture Documents
1a
TB IN CHILDREN
2
LEARNING OUTCOMES
3
TB Infection and Disease in Children
Infection
80-90%
asymptomatic
Asymptomatic Primary TB
10-20%
develop
disease Miliary/TBM
Extra-pulmonary Post-primary TB
(spine)
(adult)
4
Risk of TB infection in children
HIV infection
5
Risk of TB infection in children ( 2 )
6
Primary TB infection in children
Asymptomatic in 80-90%
5-10% may develop disease
7
Diagnosing
TB children
8a
How to diagnose TB in children
Difficult!
9
Recommended Approach
Clinical examination
TB Skin Test
10
How to diagnose TB in children
Chronic symptoms
11
Clinical signs and symptoms
12
Clinical signs and symptoms ( 2 )
13
Tools to help with the diagnosis
Score System
Chest X Ray
14
Tools to help with the diagnosis ( 2 )
15
Tuberculosis Skin Test reading
16
Mantoux Skin Test (PPD skin test)
(CDC 1995)
17
C1/M1/S4
CORRECT INCORRECT
19
Score System TB diagnosis in Children
20
Score system for TB in children
Tuberculin skin
Positive
test
Not improving
Malnutrition after 4 wks
No response to
Unexplained fever Rx
21
Local signs in score system
Lymph nodes
Joint or bone
swelling
Angle
Broad mediastinum
Radiography (hilar glands)
deformity
(spine)
Total
22
Treatment of TB in children
23
Treatment of TB in children
25
Prevention ( 2 )
Prevention of malnutrition
26
Extra Pulmonary TB in children
27
Most common forms of Extra Pulmonary TB in
Children
Miliary TB
TB Glands
TB Meningitis
28
Signs and symptoms of Extra Pulmonary TB in
children
29
Signs and symptoms ( 2 )
TB Meningitis
30
TB Meningitis ( 2 )
31
Treatment of Extra Pulmonary TB
32
Contact Management
All asymptomatic children <5yrs of age who are in close contact with a
smear positive adult should receive course of INH prophylaxis
33a
Who are child contacts
<5years
34
Contact screening
Dosage
INH 5mg/kg/day X 6 months
35
Smear + TST &
Age <5 yrs Positive
contact score sheet
>5 yrs
Screen Negative Sick
(AFB) if
symptomatic
Yes
37