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Tuberculosis is difficult to diagnose in pediatric population as they are less likely to cough up the sputum. There is a need for a gold standard test with high sensitivity and specificity and which is easy to carry out. As the endgame says, the history of contact is important in arriving at the diagnosis. Because it is difficult to isolate a Mycobacterium tuberculosis strain from children, the treatment regimen must often be based on the susceptibility pattern of the M. tuberculosis strain in the infecting adult1. If there is an adult or adolescent case in the contact history then giving chemoprophylaxis to the children in contact is recommended but reverse is not practiced i.e. if a child is the index case then adults in contact are not given the chemoprophylaxis. This may be due to weaker immune system of the child compared to adults.
Further, measurement of tuberculosis in a pediatric population is an index of active transmission or spread of TB as children invariably contract the disease from an adult or adolescent case.
1. Sass P. Tuberculosis infection and disease in children. Am Fam Physician. 1996 May 1;53(6):2087-94