Childhood TB: Separating fact from fiction

TB mainly affects the lungs but can also affect other parts of the body.

We explore childhood tuberculosis (TB) and the signs and symptoms of this infectious disease.

Would you believe us if we told you that South Africa is among the top five countries with the highest TB incidence and prevalence? In 2010 there were approximately 400, 000 – 590, 000 new TB cases in South Africa. In 2010 there were approximately 25, 000 – 38,000 TB-related deaths in South Africa. The number of people in South Africa living with HIV who also have TB is between 300, 000 and 350,000. With this in mind, it’s therefore very important to learn about this illness in order to protect yourself, and your children from this disease.

What causes Tuberculosis?

Tuberculosis is caused by Mycobacterium tuberculosis. TB mainly affects the lungs (pulmonary TB) but can also affect other parts of the body (extra-pulmonary TB). TB bacteria are expelled in airborne fluid droplets when an infected person coughs, sneezes or exhales. Be sure to teach your young ones to always cover their mouths when they cough or sneeze, and to stay clear of children who may be sick. TB is also one of approximately 20 opportunistic infections that are associated with HIV. Extra-pulmonary TB is an AIDS-defining illness.

TB signs and symptoms

TB symptoms include a persistent cough lasting longer than two weeks that may (or may not) contain blood, unexplained weight loss, drenching night sweats, loss of appetite, chest pain, and tiredness. If anyone in your family has these symptoms or anything similar to these,  consult with your doctor immediately.

Treatment options for childhood TB

Treatment for TB consists of four drugs that are active against TB: At the initiation or intensive phase of treatment, four drugs (isoniazid, rifampicin, pyrazinamide, and ethambutol) are taken for the first two months. If the initiation phase of treatment is successful the patient progresses to the continuation phase taking two drugs (isoniazid and rifampicin) for four months (or longer). The entire course of TB medication must be taken properly for the full length of time prescribed by the healthcare worker or the TB could become drug-resistant.

New research on treating childhood TB

“We can cure children with TB, but the challenge is to make the treatment more child and family-friendly by making the regimen shorter and giving children medication that is easy to swallow,” says Prof Anneke Hesseling, director of the Desmond Tutu TB Centre at SU’s Faculty of Medicine and Health Sciences.

The current treatment regimen for a child with drug-sensitive TB lasts six months, while treatment for multi-drug resistant TB can last between 12 and 18 months – including six months of daily injections during which the child is often hospitalised.

“There are fewer actual TB organisms in a child with pulmonary (lung) TB and therefore fewer organisms to kill. So there is a real opportunity to shorten the treatment for drug-sensitive TB in children,” says Hesseling.

Her research group is testing new treatment strategies to try and shorten the treatment regime for drug-sensitive TB from six to four months for children with non-severe forms of this disease. This trial will utilise a new child-friendly formulation that combines all the TB drugs (fixed dose) in a small, pleasant-tasting tablet that can be dissolved in water. Currently, adult-size tablets have to be halved, quartered, or crushed in order to administer the correct doses to infants and children.