The burden of childhood tuberculosis: A public health perspective

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dc.contributor.authorMarais B.J.
dc.contributor.authorObihara C.C.
dc.contributor.authorWarren R.M.
dc.contributor.authorSchaaf H.S.
dc.contributor.authorGie R.P.
dc.contributor.authorDonald P.R.
dc.date.accessioned2011-05-15T16:16:47Z
dc.date.available2011-05-15T16:16:47Z
dc.date.issued2005
dc.description.abstractThe burden of childhood tuberculosis (TB) reflects recent transmission within a community and the level of TB control achieved within the adult (maintenance host) population. Children contribute little to the maintenance of the TB epidemic, but they may suffer severe TB-related morbidity and mortality. This review describes the main determinants of the burden of childhood TB within a particular community. Basic infectious disease principles identify the community, and not the individual, as the central entity that sustains an epidemic. The prevalence of TB is determined by the community's exposure to Mycobacterium tuberculosis, and their vulnerability to developing disease following exposure. The main variables that influence both exposure and vulnerability are discussed. Multiple variables are linked to poverty, and it is their cumulative effect, rather than the exact degree of poverty, that seems most important. Diligent contact tracing and the use of preventive chemotherapy will reduce the TB-related suffering of children. The burden of childhood TB, however, is a reflection of our ability to control the epidemic; this remains the ultimate challenge. Current efforts to control the TB epidemic aim to reduce transmission by treating sputum smear-positive adults, while very little emphasis is placed on reducing the vulnerability of high-burden communities. Successful control of the epidemic is the most effective way to reduce the burden of childhood TB, but this will require a holistic approach that acknowledges the importance of sustainable poverty alleviation. © 2005 The Union.
dc.description.versionReview
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation9
dc.identifier.citation12
dc.identifier.issn10273719
dc.identifier.urihttp://hdl.handle.net/10019.1/13933
dc.subjectBCG vaccine
dc.subjectgamma interferon receptor
dc.subjectisoniazid
dc.subjectrifampicin
dc.subjecttuberculostatic agent
dc.subjectbacterial transmission
dc.subjectdelayed diagnosis
dc.subjectdisease predisposition
dc.subjectgenetic susceptibility
dc.subjecthigh risk population
dc.subjecthuman
dc.subjectHuman immunodeficiency virus
dc.subjectimmune deficiency
dc.subjectlung tuberculosis
dc.subjectMycobacterium tuberculosis
dc.subjectnutritional deficiency
dc.subjectpopulation exposure
dc.subjectpoverty
dc.subjectpriority journal
dc.subjectreview
dc.subjectsputum smear
dc.subjectstress
dc.subjectsystematic review
dc.subjecttuberculin test
dc.subjecttuberculosis control
dc.subjectAdult
dc.subjectAge Factors
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectCost of Illness
dc.subjectHumans
dc.subjectPrevalence
dc.subjectResidence Characteristics
dc.subjectRisk Factors
dc.subjectTuberculosis
dc.titleThe burden of childhood tuberculosis: A public health perspective
dc.typeReview
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