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Current concept in the diagnosis and treatment of childhood pulmonary tuberculosis
Authors:UK Singh  S Suman
Affiliation:Patna Medical College.
Abstract:In India, an estimated 80% of children are infected with tubercle bacillus by 10 years of age. Elimination of tuberculosis depends on finding all infectious patients and providing them with curative chemotherapy. Pulmonary tuberculosis--the most common form in children--is diagnosed when a child presents with fever, prolonged cough, weight loss, recurrent wheezing, or chest infection; the chest x-ray is suggestive of tuberculosis; and three or more of the following conditions exist: 1) Mantoux test result of 10 mm or more, 2) tuberculosis lymphadenitis by fine needle aspiration cytology, 3) grade III malnutrition, 4) no BCG vaccination, 5) positive family history of tuberculosis, and 6) recent history of pertussis or measles. Recommended, for children with pulmonary tuberculosis, is a regimen of isoniazid, rifampicin, and pyrazinamide daily for 2 months, followed by the first two drugs daily for an additional 4 months. The poor tuberculosis cure rates in most developing countries reflect patient non-compliance with treatment regimens.
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