Optimizing the Threshold to Treat Children for Latent Tuberculosis Infection: A North-East England Experience.

We assessed the impact of the updated guidelines on tuberculin skin test interpretation in the North East of England. Data on 241 children screened for latent tuberculosis infection (LTBI) between January 2011 and July 2018 were analyzed; 12.4% of children screened under the previous guidelines were treated for LTBI, compared to 33.3% under the new ones ( P < 0.001).

Diagnostic Advances in Childhood Tuberculosis-Improving Specimen Collection and Yield of Microbiological Diagnosis for Intrathoracic Tuberculosis.

There is no microbiological gold standard for childhood tuberculosis (TB) diagnosis. The paucibacillary nature of the disease, challenges in sample collection in young children, and the limitations of currently available microbiological tests restrict microbiological confirmation of intrathoracic TB to the minority of children. Recent WHO guidelines recommend the use of novel rapid molecular assays as initial diagnostic tests for TB and endorse alternative sample collection methods for children. However, the uptake of these tools in high-endemic settings remains low. In this review, we appraise historic and new microbiological tests and sample collection techniques that can be used for the diagnosis of intrathoracic TB in children. We explore challenges and possible ways to improve diagnostic yield despite limitations, and identify research gaps to address in order to improve the microbiological diagnosis of intrathoracic TB in children.