A small study by investigators from the Johns Hopkins Children's Center and Byramjee Jeejeebhoy Government Medical College in India reveals high prevalence of tuberculosis (TB) infection among young children, troubling rates of disseminated disease and alarming patterns of drug resistance.
The study's findings, published online in the open-access journal BioMed Research International, raise important questions about the direction of current research efforts, health resource allocation and the diagnosis and treatment of infected children in India and around the world, the researchers say.
"Pediatric TB is a decidedly different disease from adult TB, and our findings support the notion that childhood infections may require different prevention, diagnostic, containment and treatment tools," says lead investigator Sanjay Jain, M.D., an infectious disease specialist at the Johns Hopkins Children's Center.
The study, which involved 223 Indian children, age 5 or younger, all with suspected TB and all treated at a hospital in Pune, India, found that 12 percent (26 children) had probable or definite TB infections. In nearly half of those (12) the disease had spread beyond the lungs. Nine of the 12 children with disseminated disease had tuberculous meningitis, a highly lethal condition that occurs when the bacterium that causes TB invades the brain. In addition, four of the seven children whose diagnoses were confirmed by a laboratory culture harbored drug-resistant strains of the bacterium. Two of the four were infected with multi-drug resistant strains.
