A current review of infection control for childhood tuberculosis
Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, Suite A2210, MC 1-1481, Houston, TX 77030, USA.Tuberculosis (Edinburgh, Scotland) (Impact Factor: 2.71). 11/2011; 91 Suppl 1:S11-5. DOI: 10.1016/j.tube.2011.10.004
Tuberculosis (TB) infection control recommendations in healthcare settings were developed to decrease nosocomial transmission from adults. In the absence of pediatric-specific guidelines, these infection control recommendations have been incorporated, in almost unmodified format, for childhood TB. We will review the evidence concerning the contagiousness of TB in children, scenarios in which transmission is more likely, review United States national recommendations, and consider the family unit, as opposed to the patient, to be the transmission unit for childhood TB.
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ABSTRACT: The management of children with drug-resistant (DR) tuberculosis (TB) is challenging and it is likely that in many places the roll-out of molecular diagnostic testing will lead to more children being diagnosed. There is a limited evidence base to guide optimal treatment and follow-up in the pediatric population; in existing DR-TB guidelines the management of children is often relegated to small 'special populations' sections. This article seeks to address this gap by providing clinicians with practical advice and guidance. This is achieved through review of the available literature on pediatric DR-TB, including research studies and international guidelines, combined with consensus opinion from a team of experts who have extensive experience in the management of children with DR-TB in a wide variety of contexts and with varying resources. The review covers treatment initiation, regimen design and treatment duration, management of co-morbid conditions, treatment monitoring, adverse events, adherence promotion, and infection control, all within a multidisciplinary environment.
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