Treatment of Tuberculosis in Children
Tuberculosis is an infection with a bacteria Mycobacterium Tuberculosis. It is a different type of bacteria which is slow growing. Hence, the treatment of tuberculosis in children requires multiple drugs and a longer course. With proper treatment most children will recover well.
Treatment of tuberculosis has undergone many changes in the recent times. Treatment is based on a confirmed diagnosis and detailed reports of the microbiology namely: GeneXpert MTB PCR, MGIT TB cultures and Drug Sensitivity and Line Probe Assay (also called as Hain’s Test). This section deals with the essentials of tuberculosis treatment in children, with a focus on managing drug-sensitive cases.
Tuberculosis Treatment in Children
The treatment for TB in children typically involves a combination of anti-tuberculosis drugs over a defined period, depending on whether the TB is drug-sensitive or drug-resistant.
Key Aspects of Tuberculosis Treatment
Drug-Sensitive Tuberculosis
- For drug-sensitive TB, the treatment regimen includes first-line anti-TB medications:
- Isoniazid (H)
- Rifampicin (R)
- Pyrazinamide (Z)
- Ethambutol (E)
- Treatment duration:
- Intensive Phase: The first 2 months with all four drugs (HRZE).
- Continuation Phase: The following 4 months with isoniazid and rifampicin (HR).
Dosing and Administration
- Medications are given daily, with doses calculated based on the child’s weight.
- Fixed-dose combination tablets are preferred to improve adherence.
Drug-Sensitive Tuberculosis
- Regular follow-ups assess weight gain, symptom improvement, and side effects.<
- Baseline tests, such as liver function tests, may be done in certain cases.
Nutritional Support
- Malnutrition can worsen TB outcomes; hence, providing a balanced diet is vital for recovery.
Directly Observed Therapy (DOT)
- To ensure adherence, DOT involves healthcare workers or caregivers supervising medication intake.
Challenges in TB Treatment for Children
- Adherence Issues: Children may refuse medications due to their taste or volume.
- Side Effects: Anti-TB drugs can cause minor side effects like nausea or more severe reactions like hepatitis and skin rashes, requiring medical attention.
- Drug Resistance: Incomplete treatment can lead to multidrug-resistant TB (MDR-TB), which is harder to treat.
Managing Drug-Resistant TB in Children
In cases of multidrug-resistant TB, treatment involves second-line drugs, which may include injections or oral medications, and lasts longer (18–24 months). The details can be found in the section on Drug-Resistant TB in Children.
Tuberculosis (TB) remains a significant public health concern, particularly in children from high-burden regions. Tuberculosis treatment in children, particularly for drug-sensitive cases, is highly effective when started early and followed diligently. With proper medical care, nutritional support, and adherence to treatment, children can recover fully and avoid complications.
Conclusion
Frequently Asked Questions (FAQs)
1. How long does tuberculosis treatment last for children?
For drug-sensitive TB, the treatment typically lasts 6 months: 2 months of intensive therapy followed by 4 months of continuation therapy.
2. What is drug-sensitive tuberculosis?
Drug-sensitive TB refers to TB caused by Mycobacterium tuberculosis that responds to first-line anti-TB medications mainly Rifampicin.
3. Are there side effects of tuberculosis treatment in children?
Minor side effects like nausea or rash can occur. Severe side effects are rare but should be reported to a doctor immediately.
4. Why is adherence important in tuberculosis treatment?
Incomplete treatment can lead to drug resistance, making the infection harder to treat and more dangerous.
5. What is the most common serious side effect of TB medicines
Hepatitis is the most common side effect of TB medicine. It causes nausea, vomiting and jaundice in some cases.
